Supplements and Lifestyle Modifications for Increasing Male Fertility

Recommended Supplements with Some Evidence

The European Association of Urology (EAU) guidelines acknowledge that oxidative stress is an important contributing factor to idiopathic male infertility, and antioxidant therapy may improve sperm parameters in men with infertility, but evidence for improving live birth rates remains conflicting and of low quality 1
A randomized controlled trial (RCT) of 56 men with idiopathic infertility showed significant increases in sperm concentration, motility, normal morphology, and DNA integrity with prebiotic/probiotic supplementation compared to placebo 1

The European Association of Urology (EAU) guidelines strongly recommend weight loss for overweight or obese men as it can enhance sperm parameters 1, 2
Regular physical exercise is recommended as it can improve sperm parameters and overall health 1, 2
Smoking cessation should be encouraged as it can improve sperm quality 1, 2

The quality of evidence for most supplements is low, with many studies having methodological limitations 3
Spermatogenesis takes approximately 74 days (about 2.5 months), so any intervention requires at least this timeframe to show full effects 2
For men with severe oligoasthenoteratozoospermia (OAT) syndrome, assisted reproductive technology may be more effective than supplements alone 2
Underlying conditions such as varicocele, accessory gland infections, and hormonal imbalances should be treated as they may impact fertility outcomes 2
Testosterone therapy is contraindicated in men seeking fertility as it suppresses spermatogenesis 4, 5

For men with secondary hypogonadism seeking fertility, gonadotropin therapy (hCG with or without FSH) is recommended rather than testosterone replacement 4
Selective estrogen receptor modulators (SERMs) may increase pregnancy rates and improve sperm and hormonal parameters, but evidence quality is low 1