Fertility supplements, vitamins, herbs, alternatives to prescription pills
Natural treatment for Fertility problems or infertility with herbal and dietary supplements
October 1 2018 by Ray Sahelian, M.D.

There are quite a few herbs or natural supplements that play a role in fertility and also increase sex drive. The research in natural infertility treatment is still very early and I will update this article as more information is published. A large number of environmental and lifestyle factors may negatively affect spermatogenesis and male and female fertility. Men who carry a cellphone in their pants pocket may harm their sperm and reduce their chances of having children.

Obesity as cause, too much easting of junk food
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.

Obese men have increased levels of inflammatory markers in their seminal fluid and lower sperm quality. Chronic inflammation in male reproductive organs from obesity leads to reduced fertility.

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.
   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. Eating walnuts may also help since walnuts have a higher amount of omega-3 fatty acids than other nuts.
   Women who closely adhere to a Mediterranean-style diet rich in vegetables and fish have a higher likelihood of becoming pregnant after infertility treatment.
   Eating raw nuts could improve the quality of human sperm.

Trans fats harm
There is a possibility that high trans fats intake in the diet could lead to fertility problems in women. The more trans fats a woman eats, the more likely she is to not have healthy fertility. To maximize fertility, women should avoid all foods that list hydrogenated or partially hydrogenated oils in their ingredients.
Women's fertility is related to heart disease risk factors.

Fertility Herbs
Mac is an herb found in the Andes mountains in South America, and also known as a libido booster. A study was designed to determine the effect of a 4-month oral treatment with tablets of maca on seminal analysis in adult normal men aged 24-44 years old. Nine men received tablets of maca (1500 or 3000 mg per day) for 4 months. Serum luteinizing hormone, follicle stimulating hormone, prolactin, testosterone and estradiol levels were measured before and after treatment. Treatment with maca resulted in increased seminal volume, sperm count per ejaculation, and sperm motility, which would indicate positive effects on fertility. Serum hormone levels were not altered. Maca is also known as an aphrodisiac and is found in Passion Rx, a formula that has a combination of several potent and effective herbs.

Mucuna pruriens herb for fertility
Mucuna pruriens has been evaluated for sperm or semen quality, fertility, and health.

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 Andrology. 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.

Withania somnifera or ashwagandha
Withania has an influence on infertile males.

Acetylcysteine, NAC
I am not convinced yet that treatment with acetylcysteine NAC will help the majority of men or women with infertility. There are many other causes for this condition than would reduce the chances for NAC to be effective alone.

Reproductive Sci. 2015. N-Acetyl-Cysteine and l-Carnitine Prevent Meiotic Oocyte Damage Induced by Follicular Fluid From Infertile Women With Mild Endometriosis.

Mol Reprod Dev. 2014. Alpha-lipoic acid and N-acetylcysteine protects intensive swimming exercise-mediated germ-cell depletion, pro-oxidant generation, and alteration of steroidogenesis in rat testis. Prolonged and strenuous exercise has been proposed as a possible source of male-factor infertility. Forced intensive swimming has also been identified as one source of a dysfunctional male reproduction system. The present study evaluated the possible protective role of α-lipoic acid and N-acetylcysteine (NAC) on intensive swimming-induced germ-cell depletion in adult male rats.

L-Carnitine and Acetyl l-Carnitine may be helpful
The study was conducted in a population of 96 infertile men diagnosed with abnormal sperm and infertility. Patients orally received a formulation containing L-carnitine 145 mg, acetyl-L-carnitine 64 mg, selenium 50 mcg, coenzyme Q10 20 mg, zinc 10 mg, ascorbic acid 90 mg, cyanocobalamin 1.5 mcg, folic acid 200 mcg in combination once a day for 4 months. At the end of study, the mean sperm progressive motility showed a statistically significant increase. Prospective open-label study on the efficacy and tolerability of a combination of nutritional supplements in primary infertile patients with idiopathic astenoteratozoospermia. Arch Ital Urol Androl. 2012.

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. Placebo-controlled double-blind randomized trial on the use of L-carnitine, L-acetylcarnitine, or combination in men with idiopathic asthenozoospermia.
Fertility and Sterility 2005.

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.

Teratospermia or teratozoospermia is a condition characterized by the presence of sperm with abnormal morphology that affects fertility in males.

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

Passion Rx enhances:

Libido and sexual thoughts
Erectile function
Orgasms and climaxes
Energy and stamina 

In recent years science has made breakthroughs in the understanding of male and female sexual dysfunction. The potent herbal extracts in Passion Rx include acetylcarnitine, ashwagandha, Catuaba, Cnidium, Coleus forskohlii, Damiana, DMAE, Horny goat weed, Maca, Mucuna pruriens, Muira puama, Passion flower, Pfaffia paniculata, Rehmannia, Rhodiola, Tongkat Ali and Tribulus.

CoQ10 supplement
Q. I have a quastion regarding co-enzyme Q10 and egg quality. I've read many co-enzyme Q10 pregnancy success stories. My husband and I want to try for a baby in a few months, but I am 42 years old and I'm aware of effects of age on fertility and I want to do everything in my power to increase the egg quality. I've read that recommended dosage for improving egg quality is 600mg, with 100mg as absolute minimum, for at least three months prior conception. However, I've read some warnings that people with low blood pressure should not take co-enzyme Q10 supplement, which was very disappointing for me, since my blood pressure is often low. I was hoping you might be able to suggest of whether to start with this supplement or not, how to introduce it into my diet, and in what dosages.
   A. I am not aware of CoQ10 being effective as a treatment for infertility. Fertility issues have many different causes and each has a different treatment. I am not aware of studies that indicate CoQ10, in reasonable doses, such as 100 mg or less, have a negative influence in those with blood pressure. High amounts can cause insomnia and long term studies are not available to determine the risk from high dose use for prolonged periods.

Curcumin and turmeric
Phytother Res. 2018. Curcumin nanomicelle improves semen parameters, oxidative stress, inflammatory biomarkers, and reproductive hormones in infertile men: A randomized clinical trial. Patients were randomly assigned to one of intervention and placebo (n = 30) groups. Finally, 28 subjects in each group completed the study. Participants in the intervention group took daily 80 mg curcumin nanomicelle and those in the placebo group took daily placebo for 10 weeks. Semen analysis, anthropometric, physical activity assessments, total antioxidant capacity, malondialdehyde, inflammatory factors, and reproductive hormones were measured at the baseline and at the end of the study. At the end of study, statistically significant differences were seen in the total sperm count, sperm concentration, and motility in the intervention group to the control group. In treatment group, the total sperm count, sperm concentration, and motility levels were also statistically increased at the end of study compared to the baseline values. Curcumin nanomicelle supplementation also resulted in a statistically significant improvement in plasma levels of total antioxidant capacity, malondialdehyde, C-reactive protein, and tumor necrosis factor a in comparison to the placebo. Medical therapy of asthenoteratospermia with curcumin nanomicelle supplement could improve quality of semen parameters.

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.

Cellphones carried in pants pockets
Men who carry a cellphone in their pants pocket harm their sperm and reduce their chances of having children. Among men with no exposure to cellphones, 50 percent to 85 percent of their sperm have a normal ability to move towards an egg. This falls by an average of 8 percent among men exposed to cellphones. Similar effects are seen for sperm viability, which refers to the proportion of sperm that were alive, according to the study published June 9 2014 in the journal Environment International.

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. In rodent studies, noise stress had a negative influence on levels of FSH, LH and testosterone.
   Shift work raised a woman's risk of menstrual and fertility problems, and steady night shifts may boost the odds for miscarriage. European Society of Human Reproduction and Embryology, news release, July 9, 2013

Heavy exercise, physical stress
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.
   My note: dutasteride could cause similar problems.

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.

Problem drinking may dampen both a man's sexuality and his fertility. Some past studies have suggested that heavy drinking can take a toll on men's reproductive health. One study found that couples had a higher miscarriage risk if the man had consumed 10 or more drinks a week around the time of conception. Also, it's known that alcoholic men can develop signs of low testosterone, including shrunken testicles and enlarged breasts.

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.

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.

Fertility Research
For men with low sperm counts, sexual abstinence -- but only for a day -- increases semen quality and fertility. More prolonged sexual abstinence may actually reduce sperm numbers. After only two days of abstinence, sperm from patients with male factor infertility initiate a process of quality degradation. The findings are important for men trying to father children through in vitro fertilization, or even through the natural method.

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.
Human 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, 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 menís 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.
Fertility Sterility. 2002.
Environmental estrogens, polychlorinated biphenyls (PCBs), and phthalate esters (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.
Human Reproduction 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.

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.

Is khat useful as a fertility herb?
   It may be, see khat fertility plant information.