IT is estimated that between 10 to 15% of Malaysian couples attempting their first pregnancy meet with failure. Defective sperm function (low sperm count, poor sperm quality or both) is acknowledged to be the most common cause of more than 90% of male infertility cases.
Low sperm count and poor sperm quality are attributed to age, lifestyle factors, poor diet, genetic factors and environmental pollutants. Even though the effect of ageing on male fertility is not fully understood, genetic defects in sperm have been observed with advancing age.
Sperm formation and development (spermatogenesis) takes place in the testis, which is wrapped in a sac called the scrotum and suspended outside the body in order to maintain it between 34.4°C and 35.5°C. At temperature greater than 35.5°C due to high fevers, saunas or hot baths, it may inhibit or stopped sperm production. Even intensive exercise or driving for two hours or more produces heat around the scrotum, which may affect sperm formation and count.
Men exposed to increasing levels of free radicals, for example through cigarette smoking and environmental pollution, are much more likely to have lower sperm counts, reduced sperm motility and increased frequency of abnormally shaped sperm. The shape of the sperm is vital in order to fertilise an egg and the perfect structure is an oval head and long tail.
Free radicals cause disease and are capable of causing cells to lose their structure and their function. The sperm membrane is rich in polyunsaturated fatty acids and sensitive to oxygen-induced damage or free radical injury (this leads to impaired motility, abnormal structure and even sperm death). Usually cell damage is prevented by the anti-free radical activity of adequate levels of antioxidant nutrients and antioxidant enzymes such as superoxide dismutase (SOD), catalase, glutathione peroxidase and reductase in the male reproductive organs and the semen.
However, optimal levels of antioxidant nutrients like beta-carotene, vitamin C, vitamin E, zinc and selenium have been shown to protect sperm against damage.
It is well-documented that cigarette smoking greatly reduces vitamin C levels throughout the body and that low vitamin C in seminal fluid is associated with increased damage to the sperm’s genetic material, DNA. A study carried out on infertile male smokers found that after two months on a daily 1000mg-dose of vitamin C, their sperm quality improved so substantially that their wives became pregnant.
Vitamin E has been shown to protect the polyunsaturated fatty acids in the sperm membrane by inhibiting free radical damage and, at higher doses of 600-800IU per day, may benefit sperm count and motility.
Zinc is involved in every aspect of male reproduction, spermatogenesis and sperm motility. Deficiency of zinc is linked with low testosterone levels and poor sperm count. In a study on 37 infertile men with low sperm counts, the subjects were given 60mg elemental zinc daily for 45-50 days. The outcome was an increased sperm count. In addition, nine of the subjects successfully impregnated their wives and 22 of them normalised their testosterone levels.
Most research indicates that a combination of antioxidants provide greater protection than any single nutritional antioxidant as they work better as a team. Apart from avoiding exposure to free radicals, fertility can be enhanced by optimising the nutritional status with antioxidant supplementation and a daily diet comprising five servings each of fresh coloured fruits and vegetables, legumes and a handful of nuts and seeds.
Another useful nutrient that increases sperm vitality and viability is L-carnitine. L-carnitine is an amino acid, produced in small quantities in our brain, kidneys and liver, that is essential for the body’s own energy production and fat metabolism. Without L-carnitine, the body is unable to mobilise its fat stores for burning in the mitochondria (power houses), to be released as energy.
Out of the millions of sperm that may be produced at one ejaculation, only the healthiest ones, with sustained energy, can swim up the cervix and into the uterine cavity, where it stands a better chance of fertilising the egg that is released from the ovum. Studies show that high L-carnitine concentrations are vital for sperm energy metabolism. The higher the level of L-carnitine in the seminal fluid, the higher the sperm count and motility.
An Italian study on 100 infertile men on 2g of L-carnitine daily for four months showed that sperm count and sperm motility increased significantly.
1. ‘Low sperm count linked to food quality’, The Star Online, July 25, 2003
2. Xuan W, Lamhonwah AM, Librach C, Jarvi K, Tien I, (June 20, 2003) ‘ Characterization of organic cation/carnitine transporter family in human sperm’ ‘Biochem Biophys Res Commun’, 306(1), June 20, 2003, pp. 121-8.
3. Lenzi A, Lombardo F, Sgro P, Salacone P, Caponecchia L, Dondero F, Gandini L. ‘ Use of carnitine therapy in selected cases of male factor infertility: a double-blind crossover tria’,.’Fertil Steril’, 79(2), Feb 2003, pp. 292-300.
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