The role of food supplements in the treatment of the infertile man

Reprod Biomed Online. Oct-Nov 2003;7(4):385-91. doi: 10.1016/s1472-6483(10)61881-0.


Recently, concerns have been raised about the presumptive increased risk of serious undesirable side effects in children born after IVF and intracytoplasmic sperm injection (ICSI). These treatments must, therefore, be reserved as the ultimate option after evidence-based and cause-directed treatment of the male patient with deficient semen has been exhausted. The present authors found that sperm quality and function improved with the intake of complementary food supplementation using a combination of zinc and folic acid, or the antioxidant astaxanthin (Astacarox), or an energy-providing combination containing (actyl)-carnitine (Proxeed). Also, double blind trials showed that the latter two substances increase spontaneous or intrauterine insemination- (IUI-) assisted conception rates. Extracts of Pinus maritima bark (Pycnogenol), which inhibits the cyclo-oxygenase enzyme, reducing prostaglandin production and inflammatory reaction, and extracts of the Peruvian plant Lepidium meyenii were shown to improve sperm morphology and concentration, respectively, in uncontrolled trials. Linseed (flaxseed) oil contains alfa-linolenic acid and lignans. The former corrects the deficient intake of omega-3 essential fatty acids, which is correlated with impaired sperm motility among subfertile men. Lignans are precursors of enterolacton, which inhibits aromatase and reduces the ratio of 16-OH over 2-OH oestrogen metabolites. The resulting reduction in oestrogen load may favourably influence Sertoli cell function.

MeSH terms

  • Antioxidants / therapeutic use
  • Carnitine / metabolism
  • Dietary Supplements*
  • Estrogens / metabolism
  • Fatty Acids, Omega-3 / therapeutic use
  • Folic Acid / therapeutic use
  • Humans
  • Infertility, Male / diet therapy*
  • Infertility, Male / therapy*
  • Inhibins / metabolism
  • Lignans / metabolism
  • Lignans / therapeutic use
  • Linseed Oil / therapeutic use
  • Male
  • Pinus / metabolism
  • Plant Extracts / therapeutic use
  • Sertoli Cells
  • Spermatozoa / physiology
  • Xanthophylls
  • Zinc / therapeutic use
  • beta Carotene / analogs & derivatives*
  • beta Carotene / therapeutic use


  • Antioxidants
  • Estrogens
  • Fatty Acids, Omega-3
  • Lignans
  • Plant Extracts
  • Xanthophylls
  • inhibin B
  • beta Carotene
  • Inhibins
  • Linseed Oil
  • astaxanthine
  • Folic Acid
  • Zinc
  • Carnitine