Natural treatments for male infertility
Natural treatments for male infertility focus on addressing the inability of a man to impregnate a woman, which affects about 15% of men in America. Common causes of male infertility include low sperm count, sperm function issues, and a variety of environmental and health-related factors. Several natural treatments have been proposed, including supplements such as carnitine, antioxidants (like vitamin E and C), zinc combined with folate, and vitamins such as B12, which may support sperm quality and overall reproductive health.
Herbs like Panax ginseng, maca, and ashwagandha have also been suggested, with some studies indicating potential benefits, although evidence can be inconsistent. Caution is advised with certain substances such as licorice, melatonin, and soy, as they may negatively impact testosterone levels. While some natural options show promise, the effectiveness of these treatments can vary, and men experiencing infertility should consider consulting healthcare professionals for tailored advice. Home semen analysis tests may also assist in monitoring treatment effectiveness.
Natural treatments for male infertility
DEFINITION: Treatment of a man’s inability to impregnate a woman.
PRINCIPAL PROPOSED NATURAL TREATMENTS: None
OTHER PROPOSED NATURAL TREATMENTS: Antioxidants, astaxanthin, carnitine, coenzyme Q10, lycopene, maca (Lepidium meyenii), Panax ginseng, selenium, vitamin B12, vitamin C, vitamin E, zinc plus folate, Fenugreek (Trigonella foenum-graecum), ashwagandha (Withania somnifera)
HERBS AND SUPPLEMENTS TO USE ONLY WITH CAUTION: Andrographis, licorice, melatonin, soy, stevia
Introduction
Male infertility, the inability of a man to produce a pregnancy in a woman, occurs in about 15 percent of American men. It is often caused by measurable deficits in sperm function or sperm count. In about one-half of all cases, however, the source of the problem is never discovered. Other causes may include environmental factors, infections, hormone imbalances, injury to the testicles, undescended testicles, genetics, medications, or excessive alcohol intake.
Without any treatment, about 25 percent of reportedly infertile men help bring about a pregnancy within one year of the time they first visit a physician for treatment. In other words, infertility is often only low fertility.
Proposed Natural Treatments
Carnitine. Relatively consistent evidence suggests that various forms of the supplement L-carnitine may improve sperm function and provide benefits for male infertility. In one double-blind study, sixty men with abnormal sperm function were given either carnitine—as L-carnitine at two grams (g) per day and as acetyl-L-carnitine at one g per day)—or a placebo for six months. The results showed significant improvement in sperm function in the treated group compared with the placebo group. Similarly, a six-month, double-blind, placebo-controlled study of comparable size involving men with low sperm counts found benefits with carnitine taken alone or as carnitine combined with the anti-inflammatory drug Cinnoxicam (piroxicam cinnamate). Additionally, a two-month, double-blind, placebo-controlled, crossover study of one hundred men with various forms of infertility found probable benefits with two g daily of L-carnitine. Further studies and reviews of past studies generally support the use of carnitine for male infertility to increase sperm quality, regulate relevant hormones, and reduce reactive oxygen species that impede sperm health. Even low doses have been shown to have positive impacts.
Zinc plus folate. A twenty-six-week, double-blind, placebo-controlled trial compared the effects of treatment with zinc (sixty-six milligrams (mg) of zinc sulfate, supplying fifteen mg of zinc), folate (five mg), and zinc plus folate with placebo. A total of 108 fertile men and 103 men with impaired fertility (subfertile men) participated in the study. The two supplements combined significantly improved the sperm count and the percentage of healthy sperm in the subfertile men. Neither supplement alone produced this effect, and there was little effect of the combined therapy on fertile men. Another study also found potential benefit with zinc plus folate, leaving the use of zinc with folate for male infertility uncertain. Additionally, men with zinc deficiencies generally have lower fertility rates, so maintaining a healthy zinc intake is important when experiencing infertility.
Vitamin B12. Mild vitamin B12 deficiencies are relatively common in people over the age of sixty years. Such deficiencies lead to reduced sperm counts and lowered sperm mobility. Thus, vitamin B12 supplementation has been tried to improve fertility in men with abnormal sperm production.
In one double-blind study of 375 infertile men, supplementation with vitamin B12 produced no benefits on average in the group as a whole. However, in a particular subgroup of men with sufficiently low sperm count and sperm motility, vitamin B12 appeared to be helpful. Such “dredging” of the data is suspect from a scientific point of view, however, and this study cannot be taken as proof of effectiveness.
Antioxidants. Free radicals, dangerous chemicals found naturally in the body, may damage sperm. For this reason, many studies have evaluated the benefits of antioxidants for male infertility.
In a double-blind, placebo-controlled study of one hundred and ten men whose sperm showed subnormal activity, daily treatment with one hundred international units of vitamin E resulted in improved sperm activity and increased rate of pregnancy in their partners. Preliminary studies suggest that vitamin C may improve sperm count and function. However, a late double-blind study of thirty-one people that tested both vitamin C and vitamin E found no benefit. The dosages studied ranged from two hundred to one thousand mg daily.
According to one small double-blind study, the antioxidant carotenoid astaxanthin might enhance male fertility. Other antioxidants that have shown some promise include lycopene, coenzyme Q10, and selenium.
A major pharmaceutical company tested a miscellaneous mixture of antioxidants and reported success for male infertility. However, there is no reason to believe that either the components of this product or their exact proportions were chosen with any particular insight. Any such insight regarding the optimum formulation does not exist.
Other herbs and supplements. Preliminary evidence suggests improvements in sperm function or pregnancy rates with the use of the herb Panax ginseng. Also, the herb Lepidium meyenii (maca) is claimed to enhance fertility, but the supporting evidence is limited to animal studies, and one small uncontrolled study in humans was conducted by a single research group. Contrary to what is stated on numerous websites, maca does not appear to raise testosterone levels.
In a double-blind trial of twenty-eight men with impaired sperm activity, the use of docosahexaenoic acid, a component of fish oil, failed to improve sperm health. Another double-blind study failed to find L-arginine effective for improving pregnancy rates. One very small study failed to find magnesium helpful for infertility.
Ashwagandha may have some positive impact on male infertility. Though many tests have found that ashwagandha is ineffective, a 2022 review by the American Urological Association found testosterone levels rose by around 14 percent in males who used the herb in three studies. Other research indicates that ashwagandha may increase sperm count, semen volume, and sperm motility, but these studies are unreliable, and these findings should be further investigated. Similarly, fenugreek supplementation in some studies has increased testosterone levels.
Many other substances have been suggested as treatments for poor sperm function and infertility, including the herbs Eleutherococcus, pygeum, saw palmetto, and suma, and the supplements S-adenosylmethionine and calcium, but there is no meaningful supporting evidence for these treatments. Over-the-counter home semen analysis tests are available at many pharmacies and can help monitor the effectiveness of a natural treatment for male infertility.
Herbs and Supplements to Use Only with Caution
Soy or soy isoflavones and the herb licorice may reduce testosterone levels in men. For this reason, men with impotence, infertility, or decreased libido may want to avoid these natural products.
One report claimed tea tree oil and lavender oil have estrogenic (estrogen-like) and antiandrogenic (testosterone-blocking) effects. If this is true, men with infertility should avoid the use of these herbs. However, a literature search failed to find any other published reports that corroborate this claim.
According to a preliminary double-blind study, the supplement melatonin affects testosterone and estrogen metabolism in men, and when taken at a dose of three mg daily for six months, it may impair sperm function.
Preliminary evidence from animal studies hints that the use of some forms of peppermint at high doses might impair fertility. There is contradictory evidence from animal studies on whether the herb andrographis may impair fertility. The same is true of the herb stevia.
Bibliography
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Zhou, Shao Hu, et al. “Traditional Chinese Medicine as a Remedy for Male Infertility: A Review.” The World Journal of Men's Health, vol. 37, no. 2, 2019, pp. 175-85. doi:10.5534/wjmh.180069.