Nutrient Supplementation

Improving Male Fertility Fourfold

Cesar Mora-Esteves, MD; David Shin, MD


Semin Reprod Med. 2013;31(4):293-300. 

In This Article


The management of male-factor infertility is complex. Assisted reproductive technology is expensive and its success rate and availability are limited. Therefore, pharmacological agents with acceptable cost and success rate should be considered as part of the treatment options. When considering pharmacological management, physicians encounter a small range of options. Most therapies are not standardized due to the lack of acceptable scientific evidence, through clinical randomized studies, to support them. Currently, many drugs are used with minimal data showing any beneficial effect. For a drug to be considered effective, it should improve sperm parameters and pregnancy rates. The existing evidence supports the principles by which the use of systemic antioxidants is proposed. However, the different etiologies as well as seasonal, regional, and racial variance in sperm count and quality[109–111] make it difficult to consider the existent data absolutely valid. Furthermore, the available therapy options have produced marginally satisfactory and variable responses. A definitive conclusion cannot be drawn from the existent heterogeneous literature. Further randomized, controlled, clinical trials are needed to be able to understand the efficacy and safety of antioxidants and propose proper protocols for their use.