Abstract
Dietary supplements (DS) represent a possible approach to improve sperm parameters and male fertility. A wide range of DS containing different nutrients is now available. Although many authors demonstrated benefits from some nutrients in the improvement of sperm parameters, their real effectiveness is still under debate. The aim of this study was to critically review the composition of DS using the Italian market as a sample. Active ingredients and their minimal effective daily dose (mED) on sperm parameters were identified through a literature search. Thereafter, we created a formula to classify the expected efficacy of each DS. Considering active ingredients, their concentration and the recommended daily dose, DS were scored into three classes of expected efficacy: higher, lower and none. Twenty-one DS were identified. Most of them had a large number of ingredients, frequently at doses below mED or with undemonstrated efficacy. Zinc was the most common ingredient of DS (70% of products), followed by selenium, arginine, coenzyme Q and folic acid. By applying our scoring system, 9.5% of DS fell in a higher class, 71.4% in a lower class and 19.1% in the class with no expected efficacy. DS marketed in Italy for male infertility frequently includes effective ingredients but also a large number of substances at insufficient doses or with no reported efficacy. Manufacturers and physicians should better consider the scientific evidence on effective ingredients and their doses before formulating and prescribing these products.
Highlights
Infertility is a pathological condition defined as the inability of a sexually active, non-contracepting couple to achieve pregnancy in one year [1]
The key terms used for the search were: fertility or male reproduction or semen parameters and supplements or ingredients
To establish the efficacy of each ingredient we considered only those having at least one randomized clinical trials (RCTs) or systematic review or meta-analysis of RCTs, demonstrating a significant effect on any sperm parameters involved in male fertility
Summary
Infertility is a pathological condition defined as the inability of a sexually active, non-contracepting couple to achieve pregnancy in one year [1]. Both male and female factors can lead to infertility. It is estimated that around 10%–15% of all couples are affected by infertility, representing a global concern in most developed countries [3]. Many recent studies have emphasized the role of genital tract inflammation, incorrect lifestyles and malnutrition [4]. On this regard, weight excess and other
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