• About Us
    • Contact Us
    • Login
    • ObGFirst
  • COVID-19
  • Alerts
  • OB
  • 2T US Atlas
  • The Genome
  • GYN
    • GYN
    • Sexual Health
  • Primary Care
  • Your Practice
  • #GrandRounds
  • My Bookshelf
  • Now@ObG
  • Media
About Us Contact Us Login ObGFirst
  • COVID-19
  • Alerts
  • OB
  • 2T US Atlas
  • The Genome
  • GYN
    • 0 CME Hours
    • GYN
    • Sexual Health
  • Primary Care
  • Your Practice
  • #GrandRounds
  • My Bookshelf
  • Now@ObG
  • Media
#Grand Rounds

Do Zinc and Folic Acid Supplements Improve Male Fertility?

image_pdfFavoriteLoadingFavorite

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

METHODS:

  • Multicenter randomized clinical trial (RCT)
    • 4 US sites (2013 to 2017)
  • Participants
    • Couples: Men aged ≥18 years | Women aged 18 to 45 years
    • 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 supplementation
  • Interventions
    • 5 mg of folic acid and 30 mg of elemental zinc daily for 6 months
    • Placebo daily for 6 months
  • Study design
    • 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
  • Primary outcomes
    • Live birth
    • Semen quality parameters at 6 months after randomization
      • Sperm concentration | Motility | Morphology | Volume | DNA fragmentation | Total motile sperm count

RESULTS:

  • 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%
    • Placebo: 35%
    • Risk difference: −0.9% (95% CI, −4.7% to 2.8%)
  • Semen quality: No difference were found in the following parameters
    • Sperm concentration | Motility | Morphology | Volume | Total motile sperm count
  • However, mean DNA fragmentation was increased folic acid and zinc supplementation
    • Folic acid and zinc group: 29.7%
    • Placebo: 27.2%
    • Mean difference: 2.4% (95% CI, 0.5% to 4.4%)
  • Adverse events and side effects: GI symptoms were more common with folic acid and zinc supplementation
    • Abdominal discomfort or pain: 6%) vs 3%
    • Nausea: 4% vs 2%
    • Vomiting: 3% vs 1%

CONCLUSION:

  • Authors acknowledge limitations, including the fact that participants were from the general infertility clinic population and not subfertile men specifically
  • Male supplementation with zinc and folic acid did not significantly improve live birth rate or semen quality in couples seeking fertility treatment

Learn More – Primary Sources:

Effect of Folic Acid and Zinc Supplementation in Men on Semen Quality and Live Birth Among Couples Undergoing Infertility Treatment: A Randomized Clinical Trial

Now You Can Get ObG Clinical Research Summaries Direct to Your Phone, with ObGFirst

Try it Free  »

image_pdfFavoriteLoadingFavorite
< Previous
All #Grand Rounds Posts
Next >

Related ObG Topics:

Do Maternal Multivitamin Supplements Decrease Risk for Autism in Offspring?
Does Assisted Reproduction Increase Risk of Breast, Ovarian, Uterine Cancer?
Infertility Treatment and Childhood Development

Sections

  • COVID-19
  • Alerts
  • OB
  • GYN
    • GYN
    • Sexual Health
  • 2T US Atlas
  • The Genome
  • Primary Care
  • Your Practice
  • #Grand Rounds
  • My Bookshelf
  • Now@ObG
  • Media

ObG Library

  • Hysteroscopy
  • Fertility
  • Site Map/
  • © ObG Project/
  • Terms and Conditions/
  • Privacy/
  • Contact Us/
© ObG Project
SSL Certificate


  • Already an ObGFirst Member?
    Welcome back

    Log In

    Want to sign up?
    Get guideline notifications
    CME Included

    Sign Up

Get Guideline Alerts Direct to Your Phone
Try ObGFirst Free!

Sign In

Lost your password?

Sign Up for ObGFirst and Stay Ahead

  • - Professional guideline notifications
  • - Daily summary of a clinically relevant
    research paper
  • - Includes 1 hour of CME every month

ObGFirst Free Trial

Log In to ObG First

Please log in to access OBGFirst and the 2T Ultrasound Atlas

Password Trouble?

Sign Up for ObGFirst

  • - Access 2T US Atlas
  • - Guideline notifications
  • - Daily research paper summaries
  • - And lots more!

ObG First Free Trial

Media - Internet

Computer System Requirements

OBG Project CME requires a modern web browser (Internet Explorer 10+, Mozilla Firefox, Apple Safari, Google Chrome, Microsoft Edge). Certain educational activities may require additional software to view multimedia, presentation, or printable versions of their content. These activities will be marked as such and will provide links to the required software. That software may be: Adobe Flash, Apple QuickTime, Adobe Acrobat, Microsoft PowerPoint, Windows Media Player, or Real Networks Real One Player.

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.

Disclaimer

Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information
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.

Jointly provided by

NOT ENOUGH CME HOURS

It appears you don't have enough CME Hours to take this Post-Test. Feel free to buy additional CME hours or upgrade your current CME subscription plan

Subscribe

JOIN OBGFIRST AND GET CME/CE CREDITS

One of the benefits of an ObGFirst subscription is the ability to earn CME/CE credits from the ObG entries you read. Tap the button to learn more about ObGFirst

Learn More
Leaving ObG Website

You are now leaving the ObG website and on your way to PRIORITY at UCSF, an independent website. Therefore, we are not responsible for the content or availability of this site