We know it goes without saying that it takes two to make a baby.
And when it comes to the man’s role in the process there are so many things that go overlooked.
One topic that does seem to get a fair amount of attention (and is somewhat debated) is the question of whether or not antioxidants improve male fertility.
It would be great if you could tell the man (or sperm donor) in your life to take a few extra antioxidants and call it a day.
But is it really that simple?
When it comes to fertility issues among men, defective sperm function has been identified as one of the most common causes.
In fact, ‘male factor’ is generally seen as an alteration in sperm concentration, sperm motility, and/or sperm morphology (i.e., shape). And technically, abnormalities must be noted in at least one of two sperm analyses, typically collected 4 weeks apart.
Quick fact… oligozoospermia – a medical condition characterized by low sperm count and quality – is responsible for 90% of male-factor infertility. Obviously, this topic is obviously a big deal!
Issues identified in sperm dysfunction and male factor infertility are primarily environmental, physiologic, and genetic factors. Both environmental and physiologic factors are big contributors to oxidative stress and damage to sperm health.
But what exactly is oxidative stress?
Oxidative stress is the effect on the body resulting from oxygen species that break down and become reactive, aptly known as reactive oxygen species (ROS). The accumulation of ROS can occur when our bodies are depleted of antioxidants (more on that in a moment…)
It’s important to note that sperm cells do require some degrees of oxidative stress to achieve optimal fertilizing capacity, especially for the process referred to as hyperactivation.
However, too much oxidative stress can easily become a problem for sperm due to the chemical makeup of its structure.
Sperm contains a large amount of polyunsaturated fatty acids which make them prone to oxidation. If too much oxidative damage happens, then pre-programmed cell death (apoptosis) is activated which can contribute to fertility issues.
Quick fact… studies have shown that between 30-80% of men with fertility problems have elevated levels of oxidative stress.
As mentioned previously, both environmental and lifestyle factors can be big contributors to oxidative stress.
Here are some important factors that can put a strain on the body’s natural antioxidant defense system and actions the man in your life can take to lessen and prevent oxidative stress:
Alcohol and tobacco use:
Recommended action: We won’t get on a soap-box here… just don’t let these two factors go unaddressed! No amount of exercise, sleep, and healthy food will undo the damage done from these toxins. We recommend quitting smoking everything completely (marijuana, cigarettes, cigars, vaping, etc.) and limiting alcohol intake to no more than 6 servings per week.
Circadian rhythm dysregulation:
Sleep is a commonly overlooked cause of oxidative stress. In fact, many of our antioxidant enzymes follow a tightly timed rhythm within our bodies. When our natural circadian rhythm is disrupted by sleep deprivation, levels of oxidative stress have been shown to increase.
Recently, blue-light exposure has gotten a lot of attention for disrupting circadian rhythms, but extremely low-frequency electromagnetic fields (ELF-EMF) from electronics (e.g., cell phones) have also shown to have the same effect along with a direct link to oxidative stress.
Recommended action: Aim for a regular sleep schedule, avoid blue light at night, remove electronics from your nightstand, and get plenty of sunlight during the day.
We’ve covered the topic of environmental toxins in-depth in a prior mini-series, but it’s important to remember that exposure to chemicals and pollutants can be a major contributor to oxidative stress.
Things like pesticides and heavy metals are some of the biggest culprits, but increasing evidence suggests that plastics can have an impact too (that’s another strike against BPA).
Recommended action: Swap out plastic for glass containers whenever possible, shop for groceries according to the Dirty-Dozen, wash your produce thoroughly, and filter your drinking water.
Recurrent or ongoing psychological stress doesn’t just impact our quality of life, it also promotes oxidative damage through sustained activation of our hypothalamic-pituitary-adrenal (HPA) axis.
Recommended action: Meditation and yoga often come to mind but don’t feel like you need to sit around in uncomfortable positions while forcing positive thoughts into your subconscious.
Stress reduction can take many forms (e.g., breathing, walks in nature, journaling). What matters most is not the form, but carving out regular time to recenter yourself.
Consumption of processed foods, especially those made with industrial vegetable oils that are high in omega-6 fatty acids, introduce free radicals into our bodies.
Once consumed, these oxidized polyunsaturated fatty acids can trigger an inflammatory reaction that impairs the very cells meant to protect us from oxidative damage in the first place. They can also oxidize vitamins (A, C, and E) that serve as natural antioxidants.
Recommended action: Steer clear of processed and pre-packed foods, especially those containing canola, soybean, sunflower, peanut, or grapeseed oils – these are pro-inflammatory fats. Of course, this same advice is true for any food that is heavily fried in oil or fat for
that matter 🙁
Loading up on fruits and vegetables rich in different colors is the absolute best way to supply your body with the natural antioxidants it needs to combat oxidative stress. Adding anti-inflammatory fats from wild-caught seafood and nuts is also a great choice.
Skipping out on regular physical activity can increase levels of oxidative stress. There are so many reasons to get those 10,000 steps in a day… reducing oxidative stress is one more!
Recommended action: Aim for 30 or more minutes of exercise four to five days a week. And don’t forget the power of intermittent physical activity throughout the workday including midday walks and standing up for 10 minutes every hour.
Several studies have evaluated the ability of antioxidants to improve semen parameters and fertility outcomes. However, it’s somewhat challenging to make definitive recommendations on who is most likely to benefit given the wide range of treatment regimens as well as the inherent differences among the men in all of the studies performed thus far.
As a result, clinicians typically fall into one of four camps when deciding whether or not to recommend antioxidant supplements:
So where does that leave you and your male counterpart?
As mentioned, there is no clear-cut, single best strategy based on current evidence when it comes to choosing when to ‘prescribe’ antioxidants. Specialized testing of sperm for oxidative stress is not routinely performed and there are some concerns that taking too many antioxidants can potentially lead to decreased fertility and other potential health issues.
So from a practical standpoint, many integrative medicine specialists consider recommending antioxidants for men who have certain risk factors for increased risk of oxidative stress such as those discussed earlier in this post.
If you’ve spent any amount of time searching the internet, you probably already know that there are a wide variety of antioxidant supplements available with many sensational claims about “boosting male fertility today.”
Unfortunately, according to a study published in Urology, only 22% of the ingredients commonly included in male fertility supplements have published data relating to semen parameters and pregnancy outcomes.
Furthermore, amongst the numerous studies evaluating supplements for male fertility, there’s a wide range of the type of antioxidant supplement being given along with wide variability in outcome measures. And it’s important to note that changes in sperm parameters don’t always result in changes in pregnancy rates.
With that said, the authors of that same study published in Urology highlighted the ingredients with the most evidence, three of which are known to be potent antioxidants:
And in case you’re curious, zinc and L-carnitine made the list, but they are not traditionally classified as antioxidants.
Of course, you should know that not all studies have found antioxidants to be beneficial, including the Males, Antioxidants, and Infertility (MOXI) trial, which found that antioxidants do not improve semen parameters or DNA integrity among men with male factor infertility.
On the other hand, the most recent Cochrane review does indicate that there may be some evidence to suggest antioxidant usage among men can improve both pregnancy rates and live birth rates, albeit the level of evidence was classified as low (due to small sample size and variability amongst the intervention and outcomes being compared) and the specific antioxidant(s) of potential impact is not clear.
But then again, perhaps researchers simply haven’t found the right dose or combination of treatment yet.
After reviewing this topic, the important thing to focus on seems to be less about whether antioxidants are important for male fertility, but how one goes about reducing oxidative stress.
Oxidative stress is a clear factor contributing to male infertility and poor sperm health.
Luckily, there are a number of lifestyle changes men can make to reduce oxidative stress without having to spend money on antioxidant supplements.
However, if life circumstances or other health conditions create an internal environment that leads to high levels of oxidative stress, then it may be appropriate to discuss taking an antioxidant supplement with your healthcare provider.
Diving into antioxidant supplements for male fertility is definitely an important and loaded topic- so stay tuned for part 2 of this post.
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