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Meta-Analysis
. 2018 Nov 1;9(6):833-848.
doi: 10.1093/advances/nmy057.

The Effect of Nutrients and Dietary Supplements on Sperm Quality Parameters: A Systematic Review and Meta-Analysis of Randomized Clinical Trials

Albert Salas-Huetos  1   2 , Nuria Rosique-Esteban  1   2 , Nerea Becerra-Tomás  1   2 , Barbara Vizmanos  3 , Mònica Bulló  1   2 , Jordi Salas-Salvadó  1   2
Affiliations
Meta-Analysis

The Effect of Nutrients and Dietary Supplements on Sperm Quality Parameters: A Systematic Review and Meta-Analysis of Randomized Clinical Trials

Albert Salas-Huetos et al. Adv Nutr. .

Abstract

Infertility, which affects ∼15% of the world's population, is a global public health issue recognized by the WHO. Therefore, it is of major clinical and public health importance to investigate whether modifiable lifestyle factors-such as stress, drug use, smoking, alcohol intake, and diet-may influence human fertility. A systematic review and meta-analysis of randomized clinical trials (RCTs) from the MEDLINE-PubMed database was conducted to assess the effect of nutrients, dietary supplements, or food on sperm quality parameters. In total, 28 articles were included for qualitative analysis and 15 for quantitative meta-analysis. Total sperm concentrations [expressed as mean differences (MDs); 95% CIs, in spermatozoa (spz)/mL] were increased by selenium (3.91 × 106 spz/mL; 3.08, 4.73 spz/mL), zinc (1.48 × 106 spz/mL; 0.69, 2.27 spz/mL), omega-3 (n-3) fatty acids (10.98 × 106 spz/mL; 10.25, 11.72 spz/mL), and coenzyme Q10 (CoQ10) (5.93 × 106 spz/mL; 5.36, 6.51 spz/mL). Sperm counts were increased by ω-3 fatty acids (18.70 × 106 spz/mL; 16.89, 20.51 spz/mL) and CoQ10 supplementation (10.15 × 106 spz/mL; 8.34, 11.97 spz/mL). Sperm total motility was increased by selenium (3.30%; 2.95%, 3.65%), zinc (7.03%; 6.03%, 8.03%), ω-3 fatty acids (7.55%; 7.09%, 8.01%), CoQ10 (5.30%; 4.98%, 5.62%), and carnitines (7.84%; 6.54%, 9.13%), whereas sperm progressive motility was increased only after supplementation with carnitines (7.45%; 6.24%, 8.67%). Finally, sperm morphology was enhanced by selenium (1.87%; 1.50%, 2.24%), ω-3 fatty acid (0.91%; 0.69%, 1.13%), CoQ10 (1.06%; 0.72%, 1.41%), and carnitine (4.91%; 3.68%, 6.15%) supplementation. This meta-analysis of RCTs suggests that some dietary supplements could beneficially modulate sperm quality parameters and affect male fertility. However, results must be cautiously interpreted due to the limited sample size of the meta-analyzed studies and the considerable observed interstudy heterogeneity.The present study and the corresponding search protocol were registered at the PROSPERO registry at http://www.crd.york.ac.uk/PROSPERO as CRD42017058380.

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Figures

FIGURE 1
FIGURE 1
MDs and 95% CIs for the effects of selenium supplements on sperm concentration, sperm total motility, and sperm morphology. The forest plots of the studies use generic-inverse variance and a fixed-effects estimate method. The points for each study indicate the MD, the size of the boxes indicates the weight of the study, and the horizontal lines indicate the 95% CI for each study. The bold data represent the total number of participants for all studies, and the diamond represents the pooled MD. MD, mean difference.
FIGURE 2
FIGURE 2
MDs and 95% CIs for the effects of zinc supplements on sperm concentration, sperm total motility, and sperm morphology. The forest plots of the studies use generic-inverse variance and a fixed-effects estimate method. The points for each study indicate the MD, the size of the boxes indicates the weight of the study, and the horizontal lines indicate the 95% CI for each study. The bold data represent the total number of participants for all studies, and the diamond represents the pooled MD. MD, mean difference.
FIGURE 3
FIGURE 3
MDs and 95% CIs for the effects of ω-3 fatty acid supplements on total sperm count, sperm concentration, sperm total motility, and sperm morphology. The forest plots of the studies use generic-inverse variance and a fixed-effects estimate method. The points for each study indicate the MD, the size of the boxes indicates the weight of the study, and the horizontal lines indicate the 95% CI for each study. The bold data represent the total number of participants for all studies, and the diamond represents the pooled MD. MD, mean difference.
FIGURE 4
FIGURE 4
MDs and 95% CIs for the effects of coenzyme-Q10 supplements on total sperm count, sperm concentration, sperm progressive motility, sperm total motility, and sperm morphology. The forest plots of the studies use generic-inverse variance and a fixed-effects estimate method. The points for each study indicate the MD, the size of the boxes indicates the weight of the study, and the horizontal lines indicate the 95% CI for each study. The bold data represent the total number of participants for all studies, and the diamond represents the pooled MD. The 2 articles by Nadjarzadeh et al. (23, 25) are computed as 1 study. MD, mean difference.
FIGURE 5
FIGURE 5
MDs and 95% CIs for the effects of carnitine (LC, LAC, or LC + LAC) supplements on sperm concentration, sperm progressive motility, sperm total motility, and sperm morphology. The forest plots of the studies use generic-inverse variance and a fixed-effects estimate method. The points for each study indicate the MD, the size of the boxes indicates the weight of the study, and the horizontal lines indicate the 95% CI for each study. The bold data represent the total number of participants for all studies, and the diamond represents the pooled MD. LAC, l-acetyl carnitine; LC, l-carnitine; MD, mean difference.
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