THE IMPORTANCE OF VITAMINS IN MALE AND FEMALE INFERTILITY

DR. SULEIMAN DABIT HEAD OF ART AND GENETIC DEPARTMENT AL KHALIDI MEDICAL CENTER

Questions?
What vitamins are good for women to become more fertile?  What kinds of vitamins can men take to increase fertility?  What can I take to increase sperm mobility?

Oxidative Stress and Infertility

Counteracting All Factors of Oxidative Stress

Endogenous
Metabolism Inflammation Infections Diseases Respiratory burst Hypoxiareperfusion Stress

Exogenous
Smoking Pollution Radiation Drugs Food additives Insecticides Pesticides

Oxidative Stress Plays An Essential Role In Acceleration Of Many Chronic Diseases

Atherosclerosis

Alzheimer

Liver disease

Chronic eye disease

Male & female infertility

Threatened abortion

Immune system disorders

Diabetic nephropathy

Diabetic neuropathy

Counteracting All Factors of Oxidative Stress
Free Radicals
(Oxidative Factors)
A molecule left with unpaired electron circulating to get paired from different cells known as a free radical

Antioxidant
(Donor Factor – Protective Factor)
A molecule which prevents or slows down oxidation by donating electron to free radical while staying stable

Oxidative Stress
Affects Multiple Physiological Processes
Embryo Development And Pregnancy*

Oocyte Maturation To Fertilization*

*Ashok Agarwa l , PhD, HCLD and S a j a l G u p t a , MD

Oxidative Stress
Is A Common Pathology In Approximately

50%
Of Infertile Men*

Spermatozoa Are The Most Susceptible To ROS** Due To
Cytoplasm contains low concentrations of the scavenging enzymes Plasma membranes contain large quantities of polyunsaturated fatty acids

Rather Than All Men, Those Suffering From

Infertility
Has Significantly*

Higher Levels Of ROS & Lower Levels Of Protective Antioxidants Within Their Semen
Leadin g To

Damage to sperm membrane decrease sperm’s motility (Athenozoospermia)

Damage to sperms DNA results in infertility (Teratozoospermia)

Free Radicals
When DNA is attacked, it can be also altered by free radicals.  Ovum and sperm cells can be affected by free radical damage so are the reproductive organ and glands that produce reproductive hormones

DNA Fragmentation
Damaged DNA can cause miscarriages or birth defects and developmental problems for the future child.

Antioxidants for male subfertility (Review)
Showell MG, Brown J, Yazdani A, Stankiewicz MT, Hart RJ

This is a reprint of a Cochrane review, prepared and maintained by The Cochrane Collaboration and published in The Cochrane Library, 2011, Issue 11

[Intervention Review] Antioxidants for male subfertility
ABSTRACT

Background Between 30% to 80% of male subfertility cases are considered to be due to the damaging effects of oxidative stress on sperm. Oral supplementation with antioxidants may improve sperm quality by reducing oxidative stress. Objectives This Cochrane review aimed to evaluate the effect of oral supplementation with antioxidants for male partners of couples undergoing assisted reproduction techniques (ART). Search strategy This Review searched the Cochrane Menstrual Disorders and Subfertility Group Register, CENTRAL (The Cochrane Library), MEDLINE, EMBASE, CINAHL, Psyc INFO and AMED databases (from their inception until February 2010), trial registers, sources of unpublished literature, reference lists and they asked experts in

[Intervention Review] Antioxidants for male subfertility
Selection criteria This Review included 34 randomised controlled trials with 2876 couples in total comparing any type or dose of antioxidant supplement (single or combined) taken by the male partner of a couple seeking fertility assistance with placebo, no treatment or another antioxidant.

[Intervention Review] Antioxidants for male subfertility
Main results
Live birth: Men taking oral antioxidants had an associated statistically significant increase in live birth rate (pooled odds ratio (OR) 4.85, 95% CI 1.92 to 12.24; P = 0.0008, I2 = 0%) when compared with the men taking the control.  Pregnancy rate: there were 96 pregnancies in 15 trials including 964 couples. Antioxidant use was associated with a statistically significant increased pregnancy rate compared to control (pooled OR 4.18, 95% CI 2.65 to 6.59; P < 0.00001, I2 = 0%).  Side effects: no studies reported evidence of harmful side effects of the antioxidant therapy used.

[Intervention Review] Antioxidants for male subfertility
Authors’ conclusions The evidence suggests that antioxidant supplementation in subfertile males may improve the outcomes of live birth and pregnancy rate for subfertile couples undergoing ART cycles.

[Intervention Review] Antioxidants for male subfertility
PLAIN LANGUAGE SUMMARY CONCLUSIONS

Oxidative stress may cause sperm cell damage. This damage can be reduced by the body’s own natural antioxidant defences.

Antioxidants can be part of our diet and taken as a supplement. It is believed that in many cases of unexplained subfertility, and also in instances where there may be a sperm-related problem, taking an oral antioxidant supplement may increase a couple’s chance of conceiving when undergoing fertility treatment. This review identified 34 randomised controlled trials involving 2876 couples. Pooled findings support increases in live births and pregnancy rates with the use of antioxidants by the male partner.

Antioxidants
Antioxidants neutralize the free radicals, stopping further damage from happening and protecting the cells health.  Work as a defense system, disarming free radicals

Vitamin C
An antioxidant that protects tissue from damage and helps body absorb iron: builds healthy immune system .  Citrus fruits, red pepper, green beans, strawberries, broccoli, tomatoes, cabbages.

Vitamin C and male fertility
Improve sperm quality  Protect sperm DNA damage  Keep sperm from clumping together  Make sperm more motile.  Recommended dose of vitamin C is 500mg.

Vitamin E
Increase sperm health and motility  Help protect sperm and egg integrity.  Found in raw vegetables oils, nuts, green leafy vegetables.

Zinc
Helps produce insulin and enzymes.  Is essential in sperm production.  Red meats, poultry, beans, nuts, whole grains, fortified cereals, oysters, dairy products .  In men, increasing levels of Zinc lead to boost sperm levels, improve the form, function and quality of male sperm  Decrease male infertility

Gingko Biloba
Is one of the longest living trees on the planet (1000 years).  Memory herb.  Improve sexual function.  Prevent leading cause of male impotence (atherosclerosis).  Improve erection in men.  Help to bring fresh blood to the reproductive system in women.

Thiamin/B1
Raises energy level and regulates nervous system .  Whole grain, fortified cereals, wheat germ, organ meats, eggs, rice, pasta, berries, nuts, legumes, pork .

Riboflavin/B2
Maintains energy, good eyesight, healthy skin .  Meats, poultry, fish, dairy products, fortified cereals, eggs.

Niacin/B3
Promotes healthy skin, nerves and digestion.  High-protein foods, fortified cereals and breads, meats, fish, milk, eggs, peanuts.

Pyridoxine/B6
Helps form red blood cells, helps with morning sickness.  Chicken, fish, liver, pork, eggs, soybeans, carrots, cabbage, cantaloupe, peas, spinach, wheat germ, sunflower seeds, bananas, beans, broccoli, brown rice, oats, bran, peanuts, walnuts.

CoQ10
Involved in the production of ATP  Increase sperm motility in semen  Found in salmon and organ meat

Protein
Helps in the production of amino acids; repairs cells.  Most animal foods, meat, poultry, eggs, dairy products, beans, legumes, nuts.

Vitamins and woman Fertility

* Nutritional deficiencies have been linked to ovulation issues, hormonal imbalances, poor egg quality. * Vitamins play a significant role in fertility because they help balance hormones and organs functioning at an optimal level.

* Vitamins that increase fertility in Women.

Prepare for conception
Start taking multivitamins particularly folic acid to improve chances of pregnancy.  Eating a healthy fertility diet is of the utmost importance.  Nutrition plays a big role in having healthy fertility and experiencing a healthy pregnancy.

Important Vitamins and antioxidants for woman fertility

        

Vitamin C Omega 3 Zinc Selenium Iron Folic acid Calcium Vitamin B6 DHEA Glutathion.

Pregnant women should have a diet that consist of a variety of foods including:
Proteins,  Vitamins,  Carbohydrates,  Minerals,  Fats.

Vitamin C and women fertility
Vitamin C is a water-soluble antioxidant improves hormonal levels.  Increase fertility.  Help to absorb iron in women with a luteal phase defect.  High doses should be avoided because it can dry up cervical fluid preventing sperm from reaching the egg.

Essential fatty acids (Omega 3)
Regulate hormones in the body.  Increase cervical mucous.  Promote ovulation.  Improve the quality of uterus by increasing blood flow.

Omega 3
Contain two acids DHA and EPA  Low levels of DHA is linked to depression and other mental health issues.  During pregnancy, a lack of DHA may be associated with premature birth, low birth weight and hyperactivity in children.  Found in Sardines, walnuts, shrimp and salmon.

Zinc and woman fertility
The woman-body works with more than 300 enzymes to keep it working well.  Deficiency in Zinc lead to unbalance in estrogen and progesterone levels.  Low levels of zinc lead to miscarriages in the early stages of pregnancy.  Zinc is found in Oysters, beef, lamb, sesame seeds, yoghurt, shrimps, calf liver, green peas.

Selenium
An antioxidant that helps to protect the eggs and sperms from free radicals which can cause miscarriages and birth defects.  Necessary for the creation of sperm.

Iron
Increase fertility by helping to balance ovulation.  Women at childbearing age are at risk for developing iron deficiency anemia because menstruation, pregnancy and lactation all deplete the body natural stores of iron.

Iron
Helps in the production of hemoglobin; prevents anemia, low birth weight, and premature delivery.  Beef, pork, dried beans, spinach, dried fruits, wheat germ, oatmeal or grains fortified with iron.  Recommended preconceptional dose is15mg daily.

Folic Acid/Folate
Helps support the placenta, and prevents spina bifida and other neural tube defects .  Oranges, orange juice, strawberries, green leafy vegetables, spinach, broccoli, cauliflower, fortified cereals, peas, pasta, beans, nuts.  Recommended daily dose is 400mcg.

Calcium
Creates strong bones and teeth, helps prevent blood clots, helps muscles and nerves function.  Yogurt, milk, cheddar cheese, calcium-fortified foods like soy milk, juices, breads, cereals, dark green leafy vegetables, canned fish with bones.

Arginine (L-Arginine)
It is beneficial for improving fertility.  It is an amino acid that provides blood flow for the uterus, ovaries and genitals.  Create a healthy environment in the uterus for embryo implantation.  Increase the production of stretchy, egg-white like fertile mucus.  Recommended daily dose is 16g.

Vitamin B6
Essential for restoring hormonal balance and increasing fertility in women.  Helps balance the progestrone levels in women who are having problems conceiving  Has the ability to lengthen a women luteal phase.  The daily recommended dose of vitamin B6 is 100mg.

Glutathione
Natural master antioxidant and detoxifier.  Most important defender of a cell immune system.  Helpful for those who are experiencing immunological miscarriages or if their body is rejecting your mates sperm.

The best way to increase glutathione levels is to take 100mg of lipoic acid a day.  Found in fresh fruits, vegetables and freshly cooked meat.

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