Nutrient Supplementation

Improving Male Fertility Fourfold

Cesar Mora-Esteves, MD; David Shin, MD


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

In This Article


Selenium (Se) is an important element for normal testicular development, spermatogenesis, and spermatozoa motility and function.[55] Se may protect against oxidative DNA damage in human sperm cells. However, the exact mechanism by which Se acts is still controversial. The effects of Se could be mediated through selenoenzymes, such as phospholipid hydroperoxide glutathione peroxidase[56] and the sperm capsular selenoprotein glutathione peroxidase.[57] Selenoproteins in the human body help to maintain sperm structure integrity.[55,58] Spermatozoal effects of Se deficiency are loss of motility, breakage at the midpiece level,[59,60] and increased incidence of sperm shape abnormalities, mostly of the head.[61] Previous studies have shown a correlation between Se levels in seminal plasma and the proportion of normal sperm in a semen sample[62] as well as a significantly positive correlation levels between sperm concentration and seminal plasma Se in patients consulting for infertility.[63,64] However, these findings were not corroborated in other trials.[65,66]

Interestingly, the effectiveness of a combined treatment with Se and vitamin E in the treatment of male infertility has been examined because vitamin E works in synergy with Se as an antiperoxidant.[67,68] In their prospective, uncontrolled study, Vézina et al[69] reported that the combination of vitamin E and Se led to statistically significant increases in motility and mean seminal plasma glutathione peroxidase activity. Although there were not any documented improvements in sperm concentration, nor any achieved pregnancy in their cohort, the authors concluded that the improved sperm motion characteristics could be explained by the amplified antioxidant enzyme activity.[69] In a recent trial by Keskes-Ammar et al, improved sperm motility and lipid peroxidation markers were also similarly demonstrated after combined vitamin E and Se therapy.[70]