On this page I mention a few herbs or natural supplements that play a role in fertility and also increase sex drive. The research in this area is still very early. I will update this page as more information becomes available. Infertility treatments using prescription medications or hormones may raise the risk for birth defects.

Obesity as cause
Obesity reduces fertility in women and men. Obesity leads to menstrual irregularities, increases the risk of miscarriages and impairs the outcomes of assisted reproductive technologies and pregnancy. The reasons may be insulin excess and insulin resistance, along with higher estrogen levels. Fat cells make estrogen. These adverse effects of obesity are specifically evident in polycystic ovary syndrome. In men, obesity is associated with low testosterone levels. In massively obese individuals, reduced sperm formation leads to problems with fertility. If you have an interest in losing weight using a natural diet pill, consider Diet Rx.
   Obese men had lower levels of testosterone in their blood, as well as lower levels of luteinizing hormone (LH) and follicle-stimulating hormone (FSH) -- both essential to reproduction.

Obese men are more likely to be infertile than their slimmer peers. Every excess 10 kilograms, or 20 pounds, may cut a man's fertility by 10 percent, Dr. Markku Sallmen of the Finnish Institute of Occupational Health in Helsinki and colleagues at National Institute of Environmental Health Sciences (NIEHS) in Research Triangle Park, North Carolina, write in the September, 2006 issue of Epidemiology. Fertility is lower among men with BMIs of 26 or greater, and decreased as BMI rises. For every three-point increase in BMI, the risk of infertility rose by 12 percent. There are a number of mechanisms by which being overweight could affect fertility in males. For example, excess weight may reduce sperm concentration / count, alter hormonal balance and increase scrotal temperature, or overweight men may simply have lower libidos and less sex than normal-weight men.

Diet and food and how what we eat influences sperm health and quality
Diet may also play a role in fertility. It is possible that high sugar intake or high blood sugar may damage sperm. A diet heavy in soy products could reduce fertility by reducing sperm count. A diet high in soy products could also influence fertility.
   Women trying to get pregnant can improve their chances of conceiving by adopting a "fertility diet,"  Dr. Jorge E. Chavarro of Harvard School of Public Health endorses a fertility diet which includes a higher consumption of monounsaturated fat rather than trans fats, vegetable protein rather than animal protein, more fish, low-glycemic carbohydrates like whole grains, moderate consumption of high-fat dairy, multivitamins, and iron from plants and supplements. Dr. Jorge E. Chavarro also advises avoiding excess coffee, cigarettes, and alcohol. Increased physical activity is also important. Decreasing body weight improves the chances of fertility by reducing the risk of ovulation problems. Obstetrics and Gynecology, November 2007.
   Women who closely adhere to a Mediterranean-style diet rich in vegetables and fish have a higher likelihood of becoming pregnant after infertility treatment. Fertility and Sterility, online March 2, 2010.

Effect of Mucuna pruriens on semen profile and biochemical parameters in seminal plasma of infertile men.
Fertility Sterility. 2007.
We evaluated sixty normal healthy fertile men (controls) and 60 men undergoing fertility problem screening. Before and after the treatment, seminal plasma lipid profile, lipid peroxide, fructose, and antioxidant vitamin levels were measured. Treatment with Mucuna-Pruriens significantly inhibited lipid peroxidation, elevated spermatogenesis, and improved sperm motility. Treatment also recovered the levels of total lipids, triglycerides, cholesterol, phospholipids, and vitamin A, C, and E and corrected fructose in seminal plasma of infertile men. Treatment with mucuna pruriens increased sperm concentration and motility in all the infertile study groups. Oligozoospermic patients recovered sperm concentration significantly, but sperm motility was not restored to normal levels in asthenozoospermic men.

Tongkat ali herb could be of benefit
Eurycoma longifolia Jack in managing idiopathic male infertility. Asian J Androl. 2010.
This study investigated the effect of treatment with the proprietary standardized, water-soluble extract of the root of the Malaysian plant, Eurycoma longifolia Jack, which is thought to enhance male fertility with regard to higher semen volumes, sperm concentrations, the percentage of normal sperm morphology and sperm motility in male partners of sub-fertile couples with idiopathic infertility. A total of 350 patients were given 200 mg of the extract daily and follow-up semen analyses were performed every 3 months for 9 months. Of these 350 patients, 75 patients completed one full cycle of 3 months. Follow-up semen analyses in these patients showed significant improvement in all semen parameters. The proprietary extract of Eurycoma longifolia Jack significantly improved the sperm quality in these patients, allowing for 11 (14%) spontaneous pregnancies.

L-Carnitine and Acetyl-l-Carnitine may be helpful
Combined treatment with L-carnitine and acetyl-l-carnitine appears to improve sperm motility in men with fertility problems. In the study, 60 men with fertility problems between the ages of 20 and 40 years were randomly selected to take a combination of L-carnitine and L-acetyl-carnitine or an inactive "placebo" for 6 months. In the medical journal Fertility and Sterility, researchers at the University of Rome report that 2 months after the completion of therapy, men who took L-carnitine and acetyl l carnitine had increases in sperm concentration, forward movement, and total movement, which would likely lead to enhanced fertility. The most significant improvements in sperm motility, both forward and total, were observed in men who had the lowest levels of moving sperm when the study began. The researchers note that four spontaneous pregnancies were achieved during the study by men who had taken the combination therapy.

Taking carnitine supplements seems to improve fertility and sperm mobility in men with poorly active sperm, a problem known as asthenozoospermia. However, for carnitine to work, tiny structures within the cell called mitochondria must function properly. Mitochondria are important because they provide the energy needed for sperm to move their tail and "swim." Researchers at the University of Padua and colleagues studied 30 asthenozoospermic men divided into two groups depending on whether they had normal or abnormal mitochondria function. In patients with normal mitochondria function, movement rose from 29 percent before treatment to 41 percent after 3 months of carnitine. However, in those with abnormal function, movement held steady at about 24 percent. Thus, carnitine treatment is useful in ameliorating sperm motility (and most likely fertility) only when optimal mitochondrial function is present.

Placebo-controlled double-blind randomized trial on the use of L-carnitine, L-acetylcarnitine, or combination in men with idiopathic asthenozoospermia.
Fertility & Sterility 2005.
To evaluate the effectiveness of L-carnitine (LC) or L-acetyl-carnitine (LAC) or combined LC and LAC treatment in improving semen kinetic parameters and the total oxyradical scavenging capacity in semen. Placebo-controlled, double-blind, randomized trial. Andrology unit, Department of Internal Medicine, Polytechnic University of Marche, Italy. Sixty infertile men, ages 20 to 40 years, with the following baseline sperm selection criteria: concentration > 20 x 10(6)/mL, sperm forward motility < 50%, and normal sperm morphology > 30%; 59 patients completed the study. Patients underwent a double-blind therapy of LC 3 g/d, LAC 3 g/d, a combination of LC 2 g/d and LAC 1 g/d, or placebo. The study design was 1 month of run in, 6 months of therapy or placebo, and 3 months of follow-up evaluation. Sperm cell motility (total and forward, including kinetic features determined by computer-assisted sperm analysis) increased in patients to whom LAC was administered both alone or in combination with LC; combined LC + LAC therapy led to a significant improvement of straight progressive velocity after 3 months. The total oxyradical scavenging capacity of the semen toward hydroxyl and peroxyl radicals also increased and was positively correlated with the improvement of kinetic features. Patients with lower baseline values of motility and total oxyradical scavenging capacity of the seminal fluid had a significantly higher probability of responding to the treatment.

Passion Rx with Maca and Mucuna pruriens
Medical Doctor Formulated to enhance sexual drive and performance in Men and Women

We know Passion Rx works because users order over and over. Passion Rx provides results that are often seen within several days of use. Our feedback thus far indicates more than 80% user satisfaction. Some women notice the effects with half a capsule. Dr. Sahelian and his research staff have tested various doses and extracts of dozens of herbs from a number or raw material suppliers to determine the ideal dose and combination for optimal aphrodisiac properties with the fewest side effects. After years of trial and error, an effective proprietary blend with more than a dozen herbal extracts from the best raw material suppliers has been created which works within hours.

Iron supplement
The use of iron supplements may reduce a woman's risk of ovulatory infertility. Iron supplements may improve pregnancy rates in women with a history of infertility. Studies in women with celiac disease provide supporting evidence that adequate iron stores promote fertility.

Environmental pollution
PBDEs, or polybrominated diphenyl ethers, are hormone-disrupting pollutants that build up in the blood and tissues. In a study available in the online January 26, 2010 of Environmental Health Perspectives, researchers found that, for each 10-fold increase in PBDE blood concentration, women experience a 30 percent decrease in the odds of getting pregnant each month.

Stress
A common cause of infertility is stress. Any type of chronic stress may reduce fertility hormone levels thus lowering sperm counts in males and even turning off the female ovulatory cycle.

Heavy exercise
Men who exercise to exhaustion experience changes in their hormone levels and sperm counts. While these changes aren't permanent, heavy exercise could impair fertility in men with poor sperm counts and low hormone levels.

Prescription drugs the interfere with fertility
Drugs used for epilepsy, such as carbamazepine and valproate. decrease fertility and increase reproductive disorders in both men and women. However, these problems may subside upon withdrawal of the medications, even after years of treatment.

Common antidepressant medications damage the DNA in sperm, A study of 35 healthy men given paroxetine - sold as Paxil or Seroxat by GlaxoSmithKline - found that, on average, the proportion of sperm cells with fragmented DNA rose from 13 percent before treatment to 30 percent after just four weeks. SSRIs decrease libido in some men and women. Women taking SSRI medications are more likely to have a low birth weight baby.

Finasteride (Proscar, Propecia) can cause low sperm count and fertility problems
Propecia induced spermatogenic failure: A report of two cases.
Fertil Steril. 2007.
Two patients with azoospermia and severe oligospermia using finasteride 1 mg for hair loss. Patient A had documented azoospermia over 1 year and was initially booked for a testicular biopsy. Six months after discontinuation of finasteride 1 mg daily he showed improvement in sperm concentration to 5.5 x 10(6)/mL. Patient B had severe oligospermia with a sperm concentration of 4 x 10(6)/mL. Sperm concentration improved to 6.6 then 18.7 x 10(6)/mL at 3 and 6 months after stopping finasteride.

Avoid hot tubs
Male fertility plunges with frequent dips into the hot tub but often recovers when men stay away from long hot soaks. Dr. Paul J. Turek, from the University of California, San Francisco, identified 11 infertile men, average age 36, who habitually used a hot tub, heated Jacuzzi or hot bath for at least 30 minutes per week. The investigators evaluated the men's semen quality before and after they stopped using hot tubs, etc., for 3 or more months. After 3 to 6 months, five of the men had an average increase in total motile sperm counts of 491 percent. A large number of men who regularly take hot baths, sit in hot tubs or Jacuzzi's can improve their semen quality and possibly their fertility potential by simply discontinuing this activity.

Acupuncture and its role in fertility
Acupuncture may have a role as a treatment for certain types of male infertility. A study in the medical journal Fertility and Sterility, showed an improvement in sperm quality following acupuncture, especially the structural integrity of sperm. Researchers in Germany evaluated the benefits of acupuncture therapy in 28 men with unexplained sperm abnormalities, including malformed and motionless sperm, and low numbers of sperm. A variety of standard acupuncture points throughout the body were used. Acupuncture led to a significant increase in the percentage and number of sperm without structural defects. However, certain specific sperm abnormalities, such as immaturity, did not resolve or change with acupuncture.

Endometriosis and its effect on fertility
Women with endometriosis that involves the bowel find their chances of becoming pregnant go up substantially after they undergo "keyhole" surgery to remove the affected section of bowel.

Smoking and drinking alcohol may affect the quality of semen and sexual health. A group of investigators from Argentina found that men who both drank alcohol and smoked cigarettes were more likely to have a smaller amount of semen, a lower concentration of sperm, and a lower percentage of active sperm than abstainers. However, these semen alterations were present only in men who both smoked and drank, and not in men with one habit but not the other. For a normally fertile man, the reductions in semen quality are not enough to render him infertile, however, in men who already have fertility problems, these sperm changes might make the situation worse.

Marijuana
The likelihood of a good outcome of fertility treatment is reduced if either the man or the woman uses marijuana. Couples should not use marijuana for at least six months before starting fertility treatment. Long term marijuana use over a woman's lifetime reduces the number of eggs that can be retrieved and the number of embryos that can be transferred. American Journal of Obstetrics and Gynecology, 2006.

The use of clomiphene citrate to induce ovulation in women with fertility problems appears to be associated with an increased risk of uterine cancer.

Antioxidant intake is associated with semen quality in healthy men.
Hum Reprod. 2005.
We seek to determine whether dietary and supplement intake of specific micronutrients (zinc and folate) and antioxidants (vitamins C, E and beta-carotene) is associated with semen quality. Ninety-seven healthy, non-smoking men provided semen and were interviewed. Average daily nutrient intake from food and supplements was derived from a self-administered food frequency questionnaire. Intake levels were summarized as low, moderate and high. Semen volume, sperm concentration, total sperm count, motility, progressive motility and total progressively motile sperm count (TPMS) were measured. After controlling for covariates, a high intake of antioxidants was associated with better semen quality but, in almost all cases, there was no clear dose relationship in that moderate intake groups had the poorest semen quality. For example, positive associations were observed between vitamin C intake and sperm number as reflected in the higher mean count (P=0.04), concentration and TPMS; between vitamin E intake and progressive motility and TPMS; and between beta-carotene intake and sperm concentration and progressive motility. Folate and zinc intake were not associated with improved semen quality. In a convenience sample of healthy non-smoking men from a non-clinical setting, higher antioxidant intake was associated with higher sperm numbers and motility.

Teenagers and young men should keep their laptops off their laps because they could damage fertility. Laptops, which reach high internal operating temperatures, can heat up the scrotum which could affect the quality and quantity of men’s sperm.

Being either too thin or too heavy may lower a man's sperm count, in some cases enough to impair fertility. In a study of nearly 1,600 young Danish men, the investigators found that those with either a low or high body mass index had differences in reproductive hormones, as well as lower sperm counts than normal-weight men.

Role of environmental estrogens in the deterioration of male factor fertility.
Fertil Steril. 2002.
To evaluate the role of the environmental estrogens, polychlorinated biphenyls (PCBs), and phthalate esters (PEs) as potential environmental hazards in the deterioration of semen parameters in men with low fertility without an obvious etiology. Twenty-one infertile men with sperm counts <20 million/mL and/or rapid progressive motility <25% and/or <30% normal forms without evidence of an obvious etiology and 32 control men with normal semen analyses, fertility and evidence of conception. Semen and blood samples were obtained as part of the treatment protocol. Evaluation of semen parameters such as ejaculate volume, sperm count, motility, morphology, vitality, sperm chromatin stability, and sperm nuclear DNA integrity. PCBs were detected in the seminal plasma of infertile men but not in controls, and the concentration of PEs was significantly higher in infertile men compared with controls. Ejaculate volume, sperm count, progressive motility, normal morphology, and fertilizing capacity were significantly lower in infertile men compared with controls. The highest average PCB and PE concentrations were found in urban fish eaters, followed by rural fish eaters, urban vegetarians, and rural vegetarians. The total motile sperm counts in men with no fertility were inversely proportional to their xenoestrogen concentrations and were significantly lower than those in the respective controls. PCBs and PEs may be instrumental in the deterioration of semen quality in men with no fertility and who have no obvious etiology for their lack of fertility.

Adjuvant L-arginine treatment for in-vitro fertilization in poor responder patients.
Hum Reprod. 1999.
The objective of the present study was prospectively and randomly to evaluate the role of L-arginine in improving uterine and follicular Doppler flow and in improving ovarian response to gonadotrophin in poor responder women. A total of 34 patients undergoing assisted reproduction was divided in two groups according to different ovarian stimulation protocols: (i) flare-up gonadotrophin-releasing hormone analogue (GnRHa) plus elevated pure follicle stimulating hormone (pFSH); and (ii) flare-up GnRHa plus elevated pFSH plus oral L-arginine. During the ovarian stimulation regimen, the patients were submitted to hormonal (oestradiol and growth hormone), ultrasonographic (follicular number and diameter, endometrial thickness) and Doppler (uterine and perifollicular arteries) evaluations. Furthermore, the plasma and follicular fluid concentrations of arginine, citrulline, nitrite/nitrate (NO2-/NO3-), and insulin-like growth factor-1 (IGF-1) were assayed. All 34 patients completed the study. In the L-arginine treated group a lower cancellation rate, an increased number of oocytes collected, and embryos transferred were observed. In the same group, increased plasma and follicular fluid concentrations of arginine, citrulline, NO2-/NO3-, and IGF-1 was observed. Significant Doppler flow improvement was obtained in the L-arginine supplemented group. Three pregnancies were registered in these patients. No pregnancies were observed in the other group. It was concluded that oral L-arginine supplementation in poor responder patients may improve ovarian response, endometrial receptivity and pregnancy rate.

Women with celiac disease, a digestive disorder caused by sensitivity to gluten, have fertility and pregnancy experiences similar to women without celiac disease.

Questions
Q. i want to know if Tribulus-Terrestris herb is a good supplement. My husband and i want to get pregnant, will it help?
   A. All the information we have thus far on fertility natural treatment is on this website that you can ask your doctor to review. I have not seen such research with tribulus.

Q. I am a 36 year old woman and have a question on fertility. A reference i read stated that maca and vitex should not be used together but did not state why.
   A. We have not seen any research that would indicate that maca and vitex are helpful when used together or not beneficial when used together.

Q. I am planning on ordering arjuna supplements. Does it have any affect on male fertility?
   A. We have not seen any research regarding the role of arjuna supplements on male fertility.