Systematic Review and Critical Analysis on Dietary Supplements for Male Infertility: From a Blend of Ingredients to a Rationale Strategy

Abstract

ContentDietary supplements (DS) for male infertility marketed in Italy were evaluated for composition, concentration of ingredients, and recommended daily dose. A systematic review of literature identified ingredients potentially effective on sperm parameters and their minimal effective daily dose (mED).ObjectiveThis study was conducted in order to critically evaluate the composition and efficacy of DS marketed in Italy.Design, Setting, and ParticipantsThis was a systematic review of randomized controlled trials.Evidence AcquisitionA formula allowed us to classify the expected efficacy of each DS, based on composition. Each DS was scored and included into three classes of expected efficacy: high, low, and none.Evidence SynthesisAmong 24 supplements, 3 (12.5%) fall in high, 9 (37.5%) in lower, and 12 (50.0%) in no expected efficacy class. DS composition showed 36 substances, 18 with no literature on male fertility and 18 showing positive effect on sperm parameters, thus considered potentially active ingredients (PAI). All DS were mixtures of ingredients, containing from 2 to 17 different substances. Fifteen supplements (65.2%) contained at least 1 ingredient without evidence of efficacy and 21 formulations had PAI dosed below mED. Some PAI were associated to the improvement of specific sperm parameters.ConclusionsDS were usually blends of many substances that are frequently employed at negligible dose or without any evidence of efficacy on male reproduction. Some ingredients have been demonstrated to be effective on specific sperm parameters by RCTs. We report a list of ingredients with potential efficacy on specific sperm parameters, aimed to allow a tailored use of DS.Patient SummaryThe market of DS for male infertility offers products with potential efficacy in the improvement of sperm parameters but also many with uncertain effects. Based on current scientific literature, our study can help in the choice of DS that are more likely to be effective on specific sperm alterations, so providing the best supplementation for each patient.

Observational Cross-Sectional Study on Mediterranean Diet and Sperm Parameters

“…Therefore, nutrition is recognized to affect sperm quality through several mechanisms. As an example, the supply of essential nutrients such as zinc, selenium, essential fatty acids, folic acid, and vitamin B12 is recognized to be important in the maturation of spermatozoa [44]. In addition, weight status, the influence of physiological mechanisms involved in spermatogenesis (hormonal modulation and red-ox balance), and the physiology of the accessory glands, are strongly linked to sperm quality [45,46].…”

Dietary Supplements for Erectile Dysfunction: Analysis of Marketed Products, Systematic Review, Meta-Analysis and Rational Use

“…In recent systematic reviews by our group on DS formulation for male and female infertility [14,15], we suggested a formula to evaluate the expected efficacy of a DS based on the whole composition, specifically, each formulation was evaluated in relation to the fact that if each single active ingredient was considered an EI, and whether each one reached at least the mED based on the suggested daily dose of intake. The equation was evaluated using an adapted version of the validated scoring system that The American Heart Association has developed for analyzing scientific evidence from clinical trials [16].…”

Effect of Micronutrients and L-Carnitine as Antioxidant on Sperm Parameters, Genome Integrity, and ICSI Outcomes: Randomized, Double-Blind, and Placebo-Controlled Clinical Trial

“…Therefore, antioxidant therapies have been explored to reduce the damage of oxidative stress on male fertility [19][20][21][22][23][24][25]. The systematic review and meta-analysis study of Garolla reported that Dietary supplements for male infertility have potential efficacy in improving sperm parameters and DNA integrity even though many supplements have uncertain effects [26]. Scaruffi et al, in 2021, indicated that administering antioxidant treatment to men with low fertilization rates in their previous intracytoplasmic sperm injection (ICSI) cycles could potentially have a positive impact on the reproductive potential of their sperm [27].…”