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areas of the country where the copper content of water is naturally high there may be a general zinc deficiency, as these two minerals have to be in balance: an excess of copper can reduce zinc. Conversely, where long – term zinc supplementation is recommended, then supplementation with copper is needed.

       Vitamin B12

      Necessary to maintain fertility, there are studies that have shown an improvement in sperm motility where oral vitamin B₁₂ was given. In the latter case, around 60 per cent of those men who received an oral supplement of vitamin B₁₂ (1,500 mcg per day of methylcobalamin) had improved sperm counts.

       Vitamin E

      Certainly a deficiency in vitamin E, in animals, leads to infertility. In one human trial, the giving of 100–200 iu of vitamin E daily to both partners led to a significant increase in fertility. Vitamin E seems to reduce the amount of free – radical damage done to cells. Supplementing reduces the amount of oxidative stress on sperm cells, although it should be said that the research is at a preliminary stage and needs further work before a definite case for sperm improvement can be made.

       Co-enzyme Q10

      This is a nutrient used by the body’s cells in the production of energy. Its exact role in the production of sperm isn’t known, but there is evidence to show that as little as 10mg a day over a two – week period will improve both sperm count and motility. In one study, where men with low sperm counts were given 60mg a day over a three – month period, although no significant change was observed in most measures of sperm quality and quantity, in – vitro fertilization rates improved significantly.

       Selenium

      This is an essential trace mineral that acts with the antioxidant vitamins A, C and E, and is found in large quantities in Brazil nuts. In one double – blind study of infertile men, supplementation of 100 mcg per day of selenium for three months significantly increased sperm motility, but not sperm count.

       Calcium

      The motility of sperm is partly determined by the concentration of calcium in semen, and this mineral is also a key regulator of human sperm function. However, although we know it is important there has been no evidence to confirm that a calcium deficiency causes male infertility. Neither is there any evidence to show that calcium supplementation improves male infertility.

       Pycnogenol

      Pycnogenol (French maritime pine bark extract) is a natural antioxidant that has been found useful in maintaining the health of blood vessel walls and circulation. It works, at least in part, by subduing free radicals. A preliminary study recently presented at the 54th Annual Meeting of the American Society for Reproductive Medicine/16th World Congress on Fertility and Sterility in San Francisco reported the findings of Dr Scott J. Roseff and his colleagues at the West Essex Center for Advanced Reproductive Endocrinology in West Orange, New Jersey. In the study, four ‘subfertile’ male patients took daily supplements of Pycnogenol^® for three months. These men had had relatively high numbers of deformed sperm, as well as low sperm counts and activity. After 90 days, the percentage of structurally normal sperm – that is, non – deformed sperm – increased by an average of 99 per cent. ‘The number of deformed sperm went down and the number of normal sperm went up,’ Dr Roseff said. ‘The increase in morphologically (structurally) normal sperm is significant, although this is just a preliminary study. Pycnogenol could enable some couples to forego expensive in – vitro fertilization in favour of simpler and less expensive intrauterine insemination.’

       SAMe (S-adenosyl-L-methionine)

      SAMe is manufactured in the body from the amino acid methionine, with the aid of the co – factors vitamin B₁₂ and folic acid, and is essential in the production of the nucleic acids DNA and RNA and other proteins. Although its use as a supplement has been mainly for those suffering depression, migraines, osteoarthritis and liver disease, some preliminary research has shown that SAMe may also increase sperm activity in infertile men, although it’s too early for this to be conclusive. Also, as this amount is over the RDA, please consult a qualified nutritionist before you take it.

       Arginine

      Another amino acid, arginine is found in many foods needed to enhance sperm production. Research, of which most is still in its preliminary stages, has shown that supplementation with L – arginine over several months increased sperm count, quality and fertility. As a supplement it is also an immune – system enhancer and powerful growth – hormone stimulant, while also playing a role in circulation and sexual function. In some susceptible individuals it can also reactivate a latent herpes infection, and shouldn’t be used by people with diabetes.

       L-carnitine

      Another amino acid – like substance, made by the body and also found in meat, L – carnitine is responsible for utilizing fat in the energy centres of the body’s cells, and is essential for the formation of lean muscle in the body. It also appears to be necessary for the normal functioning of sperm cells. In preliminary studies, giving an L – carnitine supplement for four months helped to normalize sperm motility in men with poor sperm quality. In another trial, acetylcarnitine was used, and a supplement of 4 grams a day proved useful for male infertility caused by immobile sperm. However, again, this amount is well over the RDA, and should not be taken without supervision.

       DHA

      So important for sperm. The semen contains high levels of DHA. Animals fed a diet lacking in DHA showed decreased levels in their sperm.

      For more about eating well to increase fertility, see the Nutrition chapter.

       Other Important Nutrients

      These include folic acid – a nutrient just as important for men as it is for women – saw palmetto and NAC. As always, please do consult a qualified nutritionist for more information about dosages and how all these nutrients can assist fertility.

      Environment and Lifestyle Factors Affecting Sperm Production

      I think the way we live and our environment have definitely had an effect on the decline of sperm. Laptop computers, solvents, chemicals – such as those you may use for a hobby or as part of your work – ‘gender-bending’ environmental oestrogens, paints, pesticides, plastics, aluminium – all of these affect fertility. So, too, can natural substances such as genistein, a compound found in soya products and pulses, and various contaminants in drinking water. In addition, there are factors brought about by the trend towards increasingly sedentary occupations and lack of physical activity, which increase scrotal temperature and affect sperm production, count and motility. All in all, the risks are far greater than they were even 20 years ago.

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