08 Jan Study Evaluates Zinc + Folic Acid Supplements on Semen Quality

MedicalResearch.com Interview with:

Dr. Schisterman

Enrique Schisterman, Ph.D.
Chief, Epidemiology Branch, DIPHR
Eunice Kennedy Shriver National Institute of Child Health and Human Development
NICHD

MedicalResearch.com: What is the background for this study?

Response: Small studies indicated that zinc and folic acid supplements for men might improve semen quality as both zinc and folic acid are involved in DNA transcription and have antioxidant functions. But no large-scale randomized trials have been done to assess efficacy, which is important since dietary supplements are largely unregulated, and FDA cannot regulate supplements until after they come to market. Some male fertility-targeted supplements are already among the most commonly sold supplement products, despite the lack of data to guide their use. 

MedicalResearch.com: What are the main findings? 

Response: Among 2370 couples seeking infertility care, we found no beneficial effects of zinc and folic acid supplementation on semen quality, nor on live birth rates. In addition, the common thinking that dietary supplements will at least do no harm may be unfounded, as this large-scale trial found increased gastrointestinal problems like nausea, vomiting, and abdominal pain which are known side effects of zinc supplementation, as well as some indications of decreased sperm DNA quality, in men randomized to use the supplement. 

MedicalResearch.com: What should readers take away from your report?

Response: Though dietary supplements are popularized for many indications and may indeed have certain uses for which they are efficacious, folic acid (5 mg) and zinc (30 mg elemental zinc) should not be recommended to men of couples seeking infertility care. 

MedicalResearch.com: What recommendations do you have for future research as a result of this work? 

Response: Though we believe our trial’s findings that folic acid and zinc supplementation in men does not improve semen quality and birth rates is definitive, further follow-up is needed to understand the potential mechanisms of effects on sperm DNA quality and whether such effects are clinically meaningful. In addition, numerous types of other dietary supplements are currently marketed for a wide array of health conditions. We recommend that more large-scale trials be conducted among populations targeted by such products, as the public should have quality data available to make informed decisions about dietary supplement use for any purpose.

We have no relevant disclosures.

Citation:

Schisterman EF, Sjaarda LA, Clemons T, et al. Effect of Folic Acid and Zinc Supplementation in Men on Semen Quality and Live Birth Among Couples Undergoing Infertility Treatment: A Randomized Clinical Trial. JAMA. 2020;323(1):35–48. doi:https://doi.org/10.1001/jama.2019.18714

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Last Updated on January 8, 2020 by Marie Benz MD FAAD