Folate (Vitamin B9) for Sperm Quality
Folate is important for DNA integrity but supplementation has not delivered live birth benefit.
Overview
Verdict
How It Works
Dosing & Protocol
Typical dose
- Recommended dose
- 400mcg/day dietary or supplemental
- Expected timeframe
- 3-6 months
Protocol
- form
- Not applicable
- duration
- Not applicable
- co factor
- Evidence is insufficient. Folate is required for DNA synthesis in the rapidly dividing cells of spermatogenesis, and early small trials of folic acid plus zinc reported increases in sperm concentration, which drove widespread use in male fertility supplements. The question was then answered properly: the FAZST randomised trial gave 1370 couples 5 mg/day folic acid plus 30 mg/day zinc for six months and found no improvement in semen quality, no increase in live births, and more gastrointestinal side effects in the treatment group. That is a large, well-conducted negative trial, and it supersedes the earlier positive signals.
- titration
- Not applicable
- starting dose
- Not applicable as an established treatment for male fertility
Evidence
What the studies say
Effect of Folic Acid and Zinc Supplementation in Men on Semen Quality and Live Birth Among Couples Undergoing Infertility Treatment: A Randomized Clinical Trial
Schisterman EF, Sjaarda LA, Clemons T +4 more
The use of folic acid and zinc supplementation by male partners, compared with placebo, did not significantly improve semen quality or couples live birth rates.
Folic acid and zinc supplementation and live birth among couples seeking infertility treatment: the FAZST randomized clinical trial
Schisterman EF, Sjaarda LA, Clemons T +8 more
Folic acid and zinc supplementation did not improve live birth rates or semen quality
Antioxidant Treatment and the Chance to Conceive in Men Seeking Fertility Care: The SUMMER Randomized Clinical Trial
de Ligny WR, de Bruin JP, Smits RM +1 more
The antioxidant supplement (Impryl) ... contained betaine (200 mg), L-cystine (200 mg), niacin (16 mg), zinc (10 mg), vitamin B6 (1.4 mg), vitamin B2 (1.4 mg), folic acid (400 µg), and vitamin B12 (2.5 µg)
Safety
Caveats
Large negative trial. Prioritise other measures.
Less likely to help if
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