Male Infertility: Nutritional and Environmental Considerations

Studies confirm that male sperm counts are declining, and environmental factors, such as pesticides, exogenous estrogens, and heavy metals may negatively impact spermatogenesis. A number of nutritional therapies have been shown to improve sperm counts and sperm motility, including carnitine, arginine, zinc, selenium, and vitamin B12. Numerous antioxidants have also proven beneficial in treating male infertility, such as vitamin C, vitamin E, glutathione, and coenzyme Q10. Acupuncture, as well as specific botanical medicines, have been documented in several studies as having a positive effect on sperm parameters. A multi-faceted therapeutic approach to improving male fertility involves identifying harmful environmental and occupational risk factors, while correcting underlying nutritional imbalances to encourage optimal sperm production and function. (Altern Med Rev 2000;5(1):28-38.) Introduction An estimated six percent of adult males are thought to be infertile. Infertility is defined by most authorities as the inability to achieve a pregnancy after one year of unprotected intercourse. Conception is normally achieved within 12 months in 80-85 percent of couples using no contraceptive measures; thus an estimated 15 percent of couples attempting their first pregnancy will have difficulty conceiving. While certain cases of male infertility are due to anatomical abnormalities such as varicoceles, ductal obstructions, or ejaculatory disorders, an estimated 40-90 percent of cases are due to deficient sperm production of unidentifiable origin. Diagnosis and Evaluation While the focus of this article is on specific nutritional and environmental factors, there are other important diagnostic considerations when evaluating male infertility. These include endocrine abnormalities, such as hyperand hypothyroidism or hypogonadism. Prescription drugs, including phenytoin, glucocorticoids, sulfasalazine, and nitrofurantoin all may have detrimental effects on sperm production and motility. A detailed history of exposure to occupational and environmental toxins, recreational drugs and alcohol, excessive heat or radiation, and previous genitourinary infections should be elicited. Concurrent pathologies may also affect sperm production. Hepatic cirrhosis is associated with increased endogenous estrogens, which can suppress pituitary gonadotropin secretion and affect spermatogenesis. In addition, an estimated 80 percent of men with hemochromatosis have some degree of testicular dysfunction. by Steven Sinclair, ND, LAc Steven Sinclair, ND, LAc Associate Editor, Alternative Medicine Review; Private Practice, Hagerstown, Maryland. Correspondence address: Green Valley Health, 1305 Pennsylvania Ave, Hagerstown, MD 21742