Do Zinc and Folic Acid Supplements Improve Male Fertility?
BACKGROUND AND PURPOSE:
Folic acid and zinc-based supplements are being marketed to improve male fertility based on limited data
Schisterman et al. (JAMA, 2020) sought to examine whether these supplements can improve semen quality and live birth
Multicenter randomized clinical trial (RCT)
4 US sites (2013 to 2017)
Couples: Men aged ≥18 years | Women aged 18 to 45
Planning fertility treatment
Exclusion: Planning use of donor sperm or a
gestational surrogate | Were pregnant at enrollment | Presence of obstructive
azoospermia or other male infertility causes that would not benefit from
5 mg of folic acid and 30 mg of elemental zinc
daily for 6 months
Placebo daily for 6 months
Men were block randomized by study site and
planned infertility treatment
2310 couples (rounded to 2400) total were
planned to provide 90% power to detect a risk difference of 7% in live birth
Semen quality parameters at 6 months after
Sperm concentration | Motility | Morphology | Volume
| DNA fragmentation | Total motile sperm count
2,370 men were randomized | Mean age: 33 years
75% attended the final 6-month study visit
69% had semen available for analysis at 6 months after randomization
Live birth: No significant differences were found
Folic acid and zinc group: 34%
Risk difference: −0.9% (95% CI, −4.7% to 2.8%)
Semen quality: No difference were found in the following parameters
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Disclosure of Unlabeled Use
This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications.
The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.
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presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.
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