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Poor sperm quality is a frequent cause of infertility

- but dietary and lifestyle changes make a difference

Poor sperm quality is a frequent cause of infertilityApproximately one in seven couple is childless. Although there can be many underlying causes, poor sperm quality is an increasing problem. It may be caused by a lack of certain nutrients and exposure to different environmental factors, but, fortunately, it possible to improve sperm quality and increase the chances of conception by means of relevant dietary adjustments and the use of specific supplements. New research shows that epigenetic factors (factors that affect the environment of the sperm cell) determine sperm health and are therefore crucial for activating the genes of the sperm cell so the fetus can develop.

When a man ejaculates his semen into the vagina of a woman, somewhere between 60 and 450 million sperm cells are dispatched. They are able to stay alive and fertile for 2-3 days. Anatomically speaking, a sperm cell consists of a head, a midpiece, and a long, thin tail (flagellum). The head contains the nucleus with the genetic coding – or DNA. The midpiece harbors the small “powerhouses” (mitochondria) that produce the energy, which fuels the rapid tail movements needed for propulsion. The more healthy sperm cells a man is able to produce, and the faster they are able to swim, the greater are the chances that one of them reaches its target – the egg – and fertilizes it.

Get inspired by the Mediterranean diet

Evidence suggests that diet plays a vital role in sperm quality. A new, Greek study of 225 men, who frequented a fertility clinic in Athens, showed that those who consumed a predominantly Mediterranean diet had more active sperm cells compared with those who ate a less healthy diet. The study supports earlier findings, where scientists have observed that men who eat a lot of whole-grain, fruit, vegetables, legumes, and fish have better sperm quality. This is most likely because this type of diet is rich in vitamins, minerals, and essential fatty acids that protect and nourish the sperm cells.

Did you know that poor sperm quality increases the risk of miscarriage?

Vitamins, minerals, antioxidants, and fish oil

Men with poor sperm quality should attempt to eat a healthy and balanced diet, whether it is Mediterranean-style or not. The content of nutrients in the diet affects the immature sperm cells in the testicles as well as those that are fully matured, which require a lot of energy and protection of their genetic payload. Several studies have found that supplementing with vitamin C, D, and E plus beta-carotene, lycopene, zinc, selenium, Q10, and fish oil seems to improve sperm quality. Consequently, many fertility clinics offer their patients extra therapy with these nutrients as a way of improving the quality of the sperm

It is vital to protect sperm cell DNA

All cells in the human body have a nucleus that contains our genetic coding (DNA), which is our cellular blueprint. Sperm cells are smaller than other cell types and have a tail that moves. What is more, sperm cells only contain very little cytoplasm that normally produces enzymes, which help repair cellular DNA. In other words, sperm cells are not able to repair their own DNA damage and are therefore highly vulnerable to oxidative stress caused by free radicals. Factors such as stress, poisoning, inflammation, smoking, and radiation are known to increase the number of free radicals.
Free radicals are aggressive molecules that contribute to cellular damage. Studies show that in around 50% of the cases where a couple is infertile, the man’s sperm cell DNA is not properly protected. This makes the sperm cells vulnerable to something called DNA fragmentation, which not only impairs the sperm’s ability to swim but may also mean that the first sperm cell to reach the egg is not necessarily the most suited one. In other words, while the sperm cell is technically able to fertilize the egg, the egg may not develop properly because of the fragmented sperm cell DNA. As a result, the body rejects the egg. Therefore, it is vital to protect the sperm cells and their DNA against free radicals and oxidative stress, and our only shield against these threats are antioxidants such as vitamin A, vitamin C, vitamin E, selenium, and zinc.

Did you know that sperm cells are extremely vulnerable towards oxidative stress caused by free radicals, and that stress, poisoning, tobacco smoke, and radiation increase the free radical load?

Sexually active men need more selenium

All human cells contain selenium. The highest concentrations are found in reproductive glands and semen. Sperm cells are particularly dependent on selenium, as this nutrient is a vital part of (seleno)proteins in the filament, which delivers the forward propulsion. Every single ejaculation causes a loss of selenium, which is why sexually active men need more of this micronutrient. The ability to produce normal, healthy sperm cells hinges on adequate selenium reserves in the body.

Widespread selenium deficiency in Europe

The European soil lacks selenium. Low intake of fish and organ meat (offal) also contributes to our declining selenium intake. Smoking, alcohol abuse, mercury exposure, Crohn’s disease, and ulcerous colitis may also deplete the body’s selenium levels.

Selenium requirement and the use of supplements

Health authorities advise adults to get around 50-70 micrograms of selenium daily. However, studies show that this level is not enough to saturate one particular selenoprotein called Selenoprotein P (or SelP) that is used as a marker of selenium status in the blood. It takes a little over 100 micrograms of selenium each day to saturate this particular selenoprotein.
Supplements can help achieve this goal. Organic selenium yeast that contains a multitude of different organic selenium species resembles the natural variety of selenium compounds that one gets from eating a balanced diet with many different selenium sources.

The balance between omega-3 and omega-6 fatty acids is determining

All cell membranes contain omega-3 and omega-6 fatty acids. They are both involved in various biochemical processes, and it is vital to have the two types in the proper balance. Iranian scientists conducted a study where they compared 78 infertile and 82 fertile men. The cause of infertility was unknown. The scientists found that the infertile men had lower concentrations of the omega-3 fatty acids, EPA and DHA, in their blood and in their sperm cells compared with the fertile men. They also observed that infertile men had a comparatively high concentration of omega-6 in relation to omega-3. The more of the omega-6 fatty acid AA (arachidonic acid) the men had in relation to the omega-3 fatty acids, EPA and DHA, the lower the number of sperm cells in their ejaculate. What is more, the sperm cell motility was lower, and there were more signs of damage. In a follow-up study where the scientists gave supplements of omega-3 fatty acids (fish oil) or placebo to the infertile men for a 32-week period, they found that sperm quality improved in those who got omega-3. Men with poor sperm quality should there make sure to get enough omega-3 fatty acids from oily fish like herring and free-range salmon from clean waters. Alternatively, they can take high-quality fish oil supplements. It is also advisable to reduce the intake of omega-6 fatty acids from margarine, junk food, sunflower oil, corn oil, or grapeseed oil. Instead, choose olive oil that is rich in omega-9.

Q10 is necessary for the energy turnover of sperm cells

Sperm cells are among the most energy-consuming cells in the body. They use enormous amounts of energy to swim the comparatively long distance through the woman’s vagina and uterus to the fallopian tube where the fertilization of the egg takes place. It is a vital race and only few sperm cells manage to complete the 15-25 cm distance to the egg.
Coenzyme Q10 plays an essential role in helping sperm cells (and all other cells in the body) produce energy inside the mitochondria. A Q10 deficiency may therefore result in sluggish sperm cells. Coenzyme Q10 is also a very important antioxidant. Therefore, having too little of this vital compound leaves the sperm cells vulnerable to oxidative stress and DNA fragmentation.
We humans are able to synthesize most of our coenzyme Q10 in the body, but this ability tapers off with increasing age. Cholesterol-lowering drugs also decrease levels of the compound, as they block the production of coenzyme Q10 in the liver.

Q10 supplements increase the number of sperm cells as well as sperm cell motility

Italian researchers headed by specialist, Dr. A. Mancini, have demonstrated that ejaculate with a low number of sperm cells also contains comparatively little coenzyme Q10. Slovenian scientists have documented that six months of Q10 supplementation increases the sperm count and improves sperm cell motility and forward propulsion. It also reduces the number of abnormally shaped sperm cells. Both studies suggest that Q10 supplements are ideal as part of the treatment of certain types of male infertility.
At the same time, many people feel their energy levels increase when they take Q10 supplements, and this improvement is bound to benefit the couple in several different ways.

Choose a Q10 supplement that your body can absorb and utilize

Coenzyme Q10 is a lipophilic molecule, and the Q10 molecules in supplements are lipid-soluble. As a raw material, Q10 tends to form crystals that are unable to dissolve at normal body temperature. In order for these Q10 crystals to dissolve, they must be exposed to a special oil and heat treatment that frees each Q10 molecule and enables it to pass through the intestinal membrane and enter the blood. Therefore, always choose a Q10 supplement that has documentation for its quality and bioavailability. That way, you know that the Q10 effectively reaches the mitochondria of the cells.

Avoid exposure to mercury and unnecessary chemicals

A number of environmental toxins have a negative impact on our hormone balance. Scientists therefore hypothesize that some of these compounds are responsible, at least to some extent, for the declining sperm quality. Among the compounds that are under suspicion are mercury, phthalates, and certain pesticides. It is a good idea to consume organic foods and to try to avoid exposure to environmental toxins. Researchers from Hong Kong have found a link between high mercury concentrations in semen and the prevalence of deformed sperm cells and low sperm cell motility. These observations fit in nicely with studies where animals have been exposed to mercury. It is advisable to avoid mercury sources such as fish from polluted waters, especially predatory fish that are at the top of the food chain and therefore contain more pollution. Selenium can bind and inactivate mercury, provided that you have sufficiently high levels of the trace element in the body.

Avoid smoking – even passive smoking

Smoking has a negative impact on male and female fertility. Sperm from smokers contains more DNA damage, and therefore smokers should either quit smoking or attempt to consume more protective antioxidants.

Normal body weight and the right scrotal temperature are vital

Overweight men are statistically more prone to have poor sperm quality compared with
men of normal weight. This may be because fat cells produce precursors of estrogen, and because having too much scrotal fat causes the temperature in the testicles to go op. The best is to have normal weight and to wear trousers that are not too tight and don’t cause the temperature around the testicles to go up.

Radiation from cell phones, computers etc.

Several studies have shown that radiation from wireless appliances may harm sperm cells and male fertility. It is therefore a bad idea to carry your cell phone in your trouser pocket (near your groin and testicles), and to sit for long periods with your laptop computer in your lap while hooked up to a wireless router. In 2011, Polish scientists studied 2,110 men who had visited a fertility clinic in the period between 1993 and 2007. Patients who smoked, had a high alcohol consumption, or suffered from different diseases were excluded from the study. Sperm samples taken from men that used a cell phone showed that 68% of the sperm cells were abnormal, whereas only 58% of sperm cells were abnormal in the men that did not use one.
A British meta-analysis from 2014 and an Australian meta-analysis from 2016 also demonstrated that cell phone radiation is linked to impaired sperm cell motility and viability.
Argentinian scientists have analyzed semen samples from 29 healthy men. Half of the men were asked to use for four hours a laptop computer that was hooked up to the internet, while the other half served as a control group. It turned out that sperm cells from the radiation-exposed semen samples had reduced motility and a higher rate of DNA fragmentation.
Although more research is warranted in this area, it is probably safe to assume that it is a good idea to protect the testicles and sperm cells against too much radiation.

Epigenetics and the future

Epigenetics deal with how external factors and the environment affect those genes that are activated in the body’s cells. Science used to believe that male sperm cells only transferred genes during the actual conception, but today we know that a number of environmental factors can affect which genes from the mother and father are activated or not. In both men and women, the epigenetic factors are influenced by environmental conditions that include lifestyle, level of physical activity, nutrition, and exposure to environmental toxins and other harmful compounds. This can even affect the child’s health later in life.

Specific advice on supplements that can improve sperm quality

The following advice on supplements is a summary of this article and the web site “Miscarriage Research” that sums up already published science.

Supplement For increasing the number of sperm cells For increasing sperm cell activity For improving the shape of sperm cells
Vitamin C (non-acidic) X X X
Vitamin E   X X
Vitamin D X X X
Selenium (selenium yeast)   X X
Zinc X X  
Folic acid X    
Q10 X X  
(possibly in combination with less omega-6)
  X X
(fat oxidation)
X X  
Lycopene (antioxidant) X X  
Pycnogenol (antioxidant)      


Karayiannis D, Kontogianni MD et al. Association between adherence to the Mediterranean diet and semen quality parameters in male partners of couples attempting fertility. Human Reproduction 2017

Schagdarsurengin U, Steger K. Epigenetics in male reproduction: effect of paternal diet on sperm quality and offspring health. Nature Reviews Urology 2016

Safarinejad MR et al. Relationship of omega-3 and omega-6 fatty acids with semen characteristics and antioxidant status of seminal plasma: A comparison between fertile and infertile men. Clinical Nutrition 2010

Safarinejad MR. Effect of omega-3 poly-saturated fatty acid supplementation on semen profile and enzymatic anti-oxidant capacity of seminal plasma in fertile men with idiopathic oligoasthenoteratospermia: a double-blind, placebo-controlled, randomized study. Andrologia 2011

Chiu Yh et al. Fruit and vegetable intake and their pesticide residues in relation to semen quality among men from fertility clinic. Human Reproduction. 2015

Choy CMY et al. Relationship between semen parameters and mercury concentrations in blood and in seminal fluid from subfertile males in Hong Kong. Fertility and Sterility. 2002

Adams JA et al. Effect on mobile telephones on sperm quality: A systematic review and meta-analysis. Environmental International 2014

Avenado C et al. Use of laptop computers connected to internet through Wi-Fi decreases human sperm motility and increases sperm DNA fragmentation. Fertility and Sterility. 2012

Netsiden ” Miscarriage Research”,

Iver Mynsted. Dårlig sædkvalitet – årsaker og botemidler. Helsemagasinet Vitenskap og fornuft Nr 2, 2017

Lutz Shomburg. Dietary Selenium and Human Health. Nutrients 2017

Pernille Lund. Q10 - fra Helsekost til epokegørende medicin. Ny Videnskab 2014

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