Pre-Conceptual Guidelines for Men: A Review of Male Infertility Experience, including Nutrition and Lifestyle Factors

Male fertility is declining and affects approximately one in seven couples. Reasons for this are multi-factorial and the subject of on-going research, though environmental contaminants (such xenoestrogens) are believed to be contributory factors. Semen parameters can be improved through a healthy diet and nutritional supplementation has also been shown to improve semen parameters, clinical pregnancy and live birth rates significantly. Despite this, in medical care dietary modification beyond alcohol reduction is rarely recommended. The aim of this review was to consider the psychosocial impacts of infertility in males whilst assessing other nutritional and lifestyle interventions that can be used in personalized nutrition care. More tailored nutrition care needs to consider this and the taboo surrounding the male infertility experience. A systematic approach was used. Three electronic databases (CINAHL, Medline and Academic Search Complete) were searched using predetermined Boolean search terms and identified 125 papers for review. Hand searches were undertaken to ensure recent evidence was included. Duplicates were removed and predefined inclusion and exclusion criteria were applied. Narrative synthesis was used for review and to develop preconceptual guidelines. Review data indicates dietary modification or supplementation with antioxidants such as vitamin C, vitamin E, coenzyme Q10, selenium, carnitine and zinc have been shown to improve markers of male fertility and reduce markers of seminal oxidative damage. Also, a Mediterranean style diet is also associated with higher quality sperm counts. Weight loss is beneficial in terms of normalizing endocrine profiles but at present it is not possible to determine if this is the effect of weight loss alone, or the combined effect of weight loss alongside other dietary improvement. Further research is therefore needed to understand the role of the many potential confounding factors. Despite this, infertility is emotionally challenging for men and nutrition, and personalised nutrition and lifestyle therapies have potential to support men trying to conceive. Pre-conceptual nutrition and lifestyle guidelines for men have been developed from this review and the use should be considered as the basis for more tailored nutrition care in practice.