Adam recently asked about a product which claimed to improve semen. There are many of those out there, and many are vitamins and combinations of vitamins. These “nutraceuticals” can be found in drug stores, in groceries, on the internet and elsewhere.
A big problem with claims about how a nutraceutical may improve sperm and semen is that most aren’t based on studies that have a placebo, a pill that looks just like the vitamin but doesn’t have the ingredients being studied. Why is that a problem? Because nature virtually guarantees that if you start out with a bunch of men that happen to have lower than average sperm or whatever, and you measure their sperm (or whatever) before and after treatment, they will always improve. It’s an effect called “regression to the mean.” It’s like if you took twenty people with colds and gave them all a pill and waited two weeks, most would get better. Was it due to the pill or to just nature doing its thing? You don’t know. The way to figure it out would be to give half of them the pill, and half of them a pill that looked like that one but had no active ingredients, and compare how the two groups did over that two weeks. That’s called a “controlled study,” and it’s critical in figuring out if a drug or vitamin works.
Last year, two controlled studies were published looking at a vitamin involved in the energy machine inside cells called “Coenzyme Q10” and sperm. In one, men with poorly wiggling sperm who took 200 mg daily improved while taking the vitamin compared to men taking placebo. In another, men taking 300 mg daily improved in both sperm number and motility compared to men taking placebo.
They’re small studies, and bigger studies are always better. But Coenzyme Q10 might help sperm numbers and especially motility. (I have absolutely no relationship, financial or otherwise, to companies that make it.)
I have a question…My husband has a low sperm count, average is 6 million with 55% motility and only 2% morphology on the strict Krueger scale. He also has an elevated amount of white blood cells in his semen. We are currently starting our first IVF but I’m curious if you think it would be beneficial for him to see a urologist regarding the white blood cells or if he should start taking CoQ10 to see if there’s an improvement. Thank you! I also want to thank you for this blog. There isn’t a lot of info out there regarding male infertility problems.
I’m sorry, Melissa, but I can’t answer personal questions about your husband’s health. Please read the FAQ.
I didn’t think it was a personal question…I was just asking if you think he should see a urologist.
Yes. The FAQ can help find one who is familiar with this area.
Thanks for this very helpful blog. In your experience, what would be the probability for a man with low sperm motility (say less than 15% progressive) and normal count to conceive naturally?
Hi Romina, surf around the rest of this blog, and you’ll find information that addresses that 🙂
Hi doctor, maybe my question is out if this subject but I wanted to ask you as your experience, what does it cause premature ejaculation? Does man born with it or some sort of things will lead to it? Thank you
Hi Richard, regarding your other comments, a varicocele does not cause rapid ejaculation. What defines rapid ejaculation, what causes it, and what can be done about it are all great questions. I’ll put that in the list for future blog posts. Thanks for suggesting it!
why does men need to give a 5 days break while taking clomaphine citrate to imrprove
sperm count LH/FSH/TESTOSTERONE
Hi Omer, I’m not sure what this has to do with vitamins, but to answer your question, they don’t and shouldn’t.
Hi Doc
Any thoughts on Macuna?
http://www.ncbi.nlm.nih.gov/pubmed/18973898
Great question, Leigh. There’s another paper by the same group in Fertility and Sterility a year earlier. Most of the studies are in animals and very preliminary, but those two are in humans and to a degree controlled. I’d love to see the work replicated by (an)other group(s), and of course, I’d love to see studies teasing apart the active ingredient(s).
Thanks for the response Doc, appreciate your time!
One more question….I don’t have access to the full texts for the CoQ10 studies. Do you know the composition of the supplements re: ubiquinol vs ubiquinone?
oooops never mind i do. unfortunately they look to be silent of the supplement composition though :/
It’s been many years, and I’ve finally turned off comments for this WordPress blog. Why? Although it’s the first question in the FAQ, I still get comments (a bunch a day!) asking personal medical questions that I can’t answer. That’s sad and frustrating for me, because as a doctor, I really like to help patients. But this WordPress site was never meant to deliver personal medical care, and the University lawyers tell me that doing so would run afoul of State and Federal laws.
If you have specific questions about your own personal care, I urge you as outlined in the FAQ to use the American Urological Association’s Society for the Study of Male Reproduction’s search engine
I also urge you to read through all of Maledoc.com and especially the comments. For the five or so years that it was active, A lot of excellent questions were asked, including by other healthcare providers. Chances are, if you have a general question, it’s been answered here and more than once.