Once we have eliminated all toxicity or infections, can we treat or improve a low quantity or a poor sperm motility or quality? In this second part, we will talk about OTC (over the counter) medicines.
There are two known DNA deficiencies:
- Fragmentation: This is when DNA strands break into pieces.
- Abnormal chromatin structure, also called decondensation: Normal sperm chromatin structure is important for sperm fertilizing ability.
Many products are on the market advertising for sperm enhancement and fertility aides, with the idea of protecting sperm quality or repairing DNA deficiencies. They usually contain potent blends of antioxidants, vitamins, and minerals with some essential amino acids. The solution is not as clear as manufacturers think. It is important to pay attention to the recent studies.
First of all, Mother Nature has its way of attempting to rescue a deficient sperm. The egg (oocyte) actually has a limited capacity, decreasing with maternal age, to repair sperm-borne decays like DNA fragmentation, which can be partially due to oxidative stress and paternal age. However, the egg has a poor capacity to manage with an abnormal sperm chromatin structure.
Anti-oxidative vitamins (C, E and A) have largely been prescribed to patients with sperm deficiency. We would think that it makes sense. However, recent studies show that, unfortunately, these vitamins increase nucleus (or chromatin) decondensation. Therefore, their usefulness is now doubtful. On the contrary, B complex vitamins have been shown to improve chromatin condensation. We count on healthy eggs to rescue DNA fragmentation and have to administer B vitamins to enhance DNA condensation. We should minimize or avoid the use of anti-oxidative vitamins.
Other products such as L-arginine (essential amino acid), L-carnitine (derived from lysine and methionine), quercetin (a flavonoid) may also have beneficial effects. They seem to protect sperm cells against oxidative damage. But, they should not be taken for periods exceeding 3 months at a time because of their potential side effects.
Selenium, a very popular compound in supplements is to be avoided. There is no selenium deficiency scientifically known and an increase in selenium will cause a decrease in sperm motility. Iron and copper must also be avoided unless there is a proven deficiency. Zinc is the only mineral supplement proven useful to DNA condensation.
Currently, in our practice, we advise our male patients with deficient sperm motility or quality to take a B-complex vitamin, Zinc 15 mg and L-arginine one gram daily for 2 or 3 months before a repeat semen analysis or a procedure like IUI, IVF or ICSI.