Last month (May 2022), a study of obese men in Denmark, where 18% of the population is obese, found a startling connection between weight and sperm quality.

The 56 men in the study lost an average of 16.5Kg, and their sperm concentration improved by 50%. One year later, those who kept the weight off continued to see improvements, but those who re-gained the weight saw their sperm levels deteriorate again.

Seeing this study prompted us to post Lisa’s article on male fertility, originally published in the Optimum Nutrition Magazine

Male Fertility

Affecting about 17 per cent of couples, infertility is generally defined as the inability to conceive after 12 months of unprotected intercourse. Male infertility accounts for half of these cases, often as a result of poor quality sperm connected to lifestyle and diet choices.

When a man is referred for fertility tests his sperm will be checked for morphology (the percentage of sperm that are normal shaped), and sperm count, (the total number of sperm in the sample). Abnormal sperm may have defects such as a large head or two tails and are not capable of fertilising an egg. Medical treatment for male infertility is limited to surgical corrections or, in the case of infection, antibiotics, and current NICE guidelines state that there is “no effective treatment” available for unexplained male infertility. As a result many couples may turn to complementary therapies, such as nutritional therapy.

Spermatogenisis

When a man is overweight, this can have a direct impact on his sperm count. The male hormone testosterone is critical for sperm production, but obesity is a major risk factor to testosterone levels. This is attributed to the release of an enzyme from enlarged fat cells called aromatase, which irreversibly convert the testosterone to the female hormone oestrogen dial, resulting in testosterone deficiency and poor sperm production.

The testes can produce sperm at a rate of 1,000 sperm a second, a process called spermatogenisis. As with most metabolic processes, this generates by-products called reactive oxygen species (ROS), which, if left unchecked can be a major cause of damage to maturing sperm. However, a complicated system of antioxidant enzymes produced in the testes provides an inbuilt protection mechanism, which can be supported by including a high amount of antioxidant rich-foods in the diet.

The antioxidant most associated with male fertility is zinc. This is naturally found in most animal products, but particularly seafood, nuts, seeds and legumes. In rat studies, zinc has been shown to protect sperm even when the testes are exposed to potentially damaging heavy metals such as lead and cadmium.

But, as a result of clinical trials over the years, the antioxidants vitamins C, A and E each has claimed to a protective role for sperm.

Lycopene, a nutrient found in tomatoes and a source of vitamin A, has had particularly good results in clinical trials. In one small study of 30 men, in which participants were given 2mg of lycopene in a supplement, twice a day for three months, 66 per cent showed an improvement in sperm concentration, 53 per cent in improved sperm motility and 46 per cent in sperm morphology.

Because lycopene is fat-soluble, it is more easily absorbed if combined with a small amount of fat, such as olive oil, and (if taken through tomatoes) if the tomatoes are cooked. Just one tablespoon of tomato paste contains approximately 7mg of lycopene, so this is a nutrient that can easily be topped up in the daily diet.

Other foods that have been the subject of clinical trials include pomegranate fruit extract and rhizome of greater galangal (a root closely related to ginger and turmeric), which was positively associated with sperm creation, count and mobility, and also maca root, a Peruvian herb that is popular in teas or as an additive to smoothies. Omega-3 fats from oily fish, nuts and seeds have also been associated with increased sperm quality and quantity.

CoQ10 is an antioxidant that has been measured in seminal fluid; in one study it was found that the concentration correlated with sperm count and motility. CoQIO is found in a wide range of animal sources, such as oily fish and organ meats, and plant sources such as wholegrains. In the past it has been found that that people ate less than 1Omg of CoQl0 per day, however, studies into CoQlO and sperm have used high doses in excess of 200mg a day.

Motility

Sperm need to be good swimmers to reach their target, the egg. The amino acid arginine is generally listed as the number one ingredient in male fertility supplements. One reason given for arginine’s benefit is that it is used to form a chemical called spermine, which triggers the sperm to move. lt is also metabolised into nitric oxide, which improves sperm mobility. Additionally arginine is used in the production of another amino acid called carnitine. This acts as an energy source for sperm, and as an antioxidant to protect an enzyme called lactate dehydrogenase that is unique to sperm energy production.

Amino acids are component parts of proteins, and the best food sources for both arginine and carnitine are lean meats such as chicken and turkey, and nuts and seeds for vegetarians and vegans.

It seems there is no end to the number of body functions that are improved by having good vitamin D levels and, in the case of male fertility, one function of vitamin D is to help sperm to absorb calcium, which in turn increases their motility.

Anti-Nutrients

There has been some debate as to whether and how alcohol consumption affects male fertility. Back in 2014, a paper published in the BMJ caused headlines when it reported that a study of more than 1,200 men had found that just five units of alcohol a week impacted sperm count and morphology. This is the equivalent of two pints of standard strength lager per week, The study went on to show that the more alcohol consumed, the greater the impact on sperm count, with men who drank 40 units per week having 33 per cent less sperm in their samples.

It has also been claimed that going organic could be better for sperm morphology, and one study claimed that men eating fruit and vegetables with a higher amount of pesticides had more damaged sperm as a consequence. However, earlier studies were inconclusive and more research into this subject would be welcome.

Conclusion

Male fertility is one area in which nutritional therapy can provide advice where there is little or no medical solution available. Although it may take three to six months, a comprehensive dietary programme offers a chance to improve sperm quantity and morphology; and, given the evidence, improving weight and diet may be all that is needed. However, if considering taking supplements, consult your GP or a registered nutritional therapist, and always read the manufacturer’s instructions.

Our Mens Health seminar includes male fertility as one of the key topics affecting mens health, alongside cardiovascular health and mental wellbeing. Our Health Checks can help identify risks of disease and motivate your staff to make positive changes to their diets and lifestyle. Call us now on 07966 478974 or email info@vitalhealthnutrition.co.uk

The article was first published in the Summer 2016 edition of #ion_nutrition Optimum Nutrition Magazine