Infertility: Nutritional considerations

• Antioxidant supplementation: Controlled studies of high–dose combinations of antioxidant supplements, including vitamin C (>200 mg/day), vitamin E (200–600 I.U./day), and selenium (100–200 μg/day), demonstrated improvements in sperm function and pregnancy rates.
  
  In infertile women, evidence of a role for antioxidant supplementation in achieving pregnancy is limited. Some studies have suggested a potential role for high–dose (750 mg/day) vitamin C and combinations of antioxidants, iron, and arginine supplements in achieving pregnancy.
  
• Carnitine: Carnitine is an amino acid that is concentrated within the epididymis (a small tube connected to the testicles) where it contributes directly to the energy supply required by sperm for growth and function. Supplementation with carnitine or acetylcarnitine (1.0–2.0 grams/day) has been shown to increase the number and function of sperm and the rate of pregnancy.
  
• Gluten–free diet in individuals with celiac disease: Celiac disease can impair fertility by delaying puberty, causing amenorrhea (lack of menstrual periods), causing malabsorption of key nutrients, or causing miscarriage. In individuals with celiac disease, fertility may be improved by following a gluten–free diet.
  
• Alcohol intake may impair fertility. Couples having fertility problems are advised to avoid alcohol. In men, alcohol consumption contributes not only to impotence, but also to a reduction of blood testosterone and impairment of sperm maturation. Alcohol consumption is also associated with decreased fertility in women.