This is one of a series of news items from abstracts of studies presented at the 2013 Annual Meeting of the American Society for Reproductive Medicine as complied by Dr. David Meldrum, former partner and Scientific Director of Reproductive Partners. We appreciate the enormous amount of work it takes to compile and comment on these abstracts.
In an abstract reported at the 2013 ASRM meeting, processed meat intake was associated with lower sperm morphology, while fish intake was associated with better sperm morphology. Another randomized controlled study showed that 1800 mg per day of omega-3 fatty acids over 7 months was associated with improved sperm parameters, including morphology. Although lower doses and shorter durations were not examined, a period of loading may be necessary for men not accustomed to eating fish. Omega-3’s are important constituents of sperm membranes, but also reduce oxidative stress.
The testicles and ovaries need a good blood supply, which brings more nutrients, oxygen and hormones so that their functions can be optimized. For example, in the male, two agents known to increase nitric oxide, and therefore blood flow, increased the level of testosterone in the bloodstream and also significantly improved semen volume, sperm numbers, sperm motility, and sperm morphology. Testosterone production within the testicles is an important stimulator of normal sperm production.
The specific regimen that improved testicular function was a combination of 3 grams daily of L-arginine and 80 mg of pycnogenol. L-citrulline at a dose of 2 grams per day raises the circulating levels of L-arginine more than 3 grams of L-arginine and therefore should have the same or a greater effect because it also acts as an intracellular source of L-arginine. These two agents increase the production of nitric oxide, which increases blood flow by relaxing the arteries supplying nutrients, oxygen, and hormones to the testicles.
The antioxidant capacity of the semen and of the fluid and cells surrounding the egg decreases with age and is lower in individuals with poor sperm and egg quality. Potent oxidants increase with age and accumulate from eating foods cooked at a high heat such as with grilling and barbecuing and with higher blood sugar levels, as with obesity or excessive sugar consumption.
In the male, oxidation products correlate with poor semen parameters, particularly motility, and also correlate with fragmentation of the sperm DNA. Sperm require high levels of antioxidants in the surrounding seminal fluid because as they shed most of their cytoplasm to make them more motile, they lose their normal intracellular antioxidant defenses.
Examples of potent antioxidants are berries, green tea, red wine, chocolate, and a commercial antioxidant called pycnogenol. However, for the female, we do not recommend chocolate, because of its content of caffeine, or wine due to the alcohol. Men desiring fertility also would be best to avoid or minimize alcohol intake. For the female we suggest only one cup of decaffeinated green tea per day, but the absorption of antioxidants can be markedly enhanced by adding 50 mg of Vitamin C to each cup. In the male, high doses of vitamin C and vitamin E may be helpful to minimize fragmentation of the DNA of the sperm. Sperm fragmentation increases with age, particularly over age 40, and is correlated with low antioxidant capacity of the semen. In a well-designed study, 1000 mg of Vitamin C and 1000 mg of Vitamin E decreased the percentage of the sperm having fragmented DNA from 22% to 9%, whereas it was unchanged with placebo. Most likely these benefits would also be seen with other potent antioxidants such as pycnogenol. Because the antioxidant capacity of 1000 mg of vitamin C is similar to that of 40 mg of pycnogenol, a dose of 40-60 mg of pycnogenol could logically be substituted if someone prefers not to take this large dose of vitamin C or experiences heartburn with such a high dose. Long term ingestion of 400 IU or more of vitamin E has been implicated in reduced overall health. Although no short term adverse effects would be expected with 1,000 IU, one could reduce the vitamin E dose to 200 IU and substitute 40-60 mg of pycnogenol. CAUTION: If you are taking aspirin at any dose we do not suggest taking vitamin E. Vitamin E increases the effects of aspirin on blood clotting (women are often advised to take a baby aspirin per day during an IVF cycle and older men sometimes take aspirin for protection against heart attacks). A better diet with more antioxidants, fruits and vegetables and less meat, dairy and processed products has also been correlated with better semen quality.