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]]>Sperm, which holds the male DNA, must be able to move back and forth and propel itself to penetrate the female egg. Fertile males have healthy sperm that swim well, but males with impaired fertility may have a lower sperm count, or sperm that do not swim as well. Zinc may play a role in the development and overall quality and quantity of sperm.
Zinc has antioxidative properties and plays an important role in scavenging reactive oxygen species. We hypothesized that in the absence of Zn, the possibility of increased oxidative damage exists that would contribute to poor sperm quality. Therefore, measurement of seminal Zn in the seminal plasma of males with a history of subfertility or idiopathic infertility is necessary and can be helpful in fertility assessment.
The mineral zinc is naturally present in certain foods, and it is added to other foods. The National Institutes of Health notes that zinc is involved in immune function, wound healing, protein synthesis, DNA synthesis and cell division. Zinc is the second most common trace mineral in the body, behind iron, and is present in every cell in the body. Males 14 years and up need 11 milligrams of zinc per day – an amount easily obtained through a healthy diet plus a multivitamin.
Zinc may play an important role in the development of sperm, also known as spermatogenesis. A 2009 a study published on the Proceedings of the National Academy of Sciences website found that the concentration of zinc in the testes increases during spermatogenesis. The study also found that zinc deficiencies reduced sperm motility. The study concluded that zinc is a vital mineral in the development of sperm and the regulation of sperm motility. Still, the extent of zinc’s role in spermatogenesis is not fully understood.
A 2009 study published in “Nutrition Research” hypothesized that due to zinc’s important antioxidant role, a deficiency would increase oxidative damage and promote lower quality sperm. The study found that seminal zinc, in both fertile and infertile males, correlated significant with sperm count. The conclusion was that zinc deficiency is, in fact, a risk factor for low sperm quality and male infertility, for which there is no other apparent cause.
A 2002 study published in “Fertility and Sterility” tested the effects of zinc plus the vitamin folate on fertility-impaired males. The study found that while zinc and folate, each on their own, did not improve sperm count, when combined, the two supplements significantly improved sperm count, as well as the percentage of healthy sperm, in fertility-impaired males. Another study published in the “International Journal of Andrology” also found benefits in combining zinc and folate on fertility-impaired males.
In conclusion zinc is an important element required for healthy sperms and male fertility.
Dr. Sharmila Majumdar
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]]>The post Idiopathic Infertility appeared first on Dr. Sharmila Majumdar - Sexologist Psychoanalyst in Hyderabad.
]]>In unexplained infertility abnormalities are likely to be present but not detected by current methods. Possible problems could be that the egg is not released at the optimum time for fertilization, that it may not enter the fallopian tube, sperm may not be able to reach the egg, fertilization may fail to occur, transport of the zygote may be disturbed, or implantation fails. It is increasingly recognized that egg quality is of critical importance and women of advanced maternal age have eggs of reduced capacity for normal and successful fertilization. Also, polymorphisms in folate pathway genes could be one reason for fertility complications in some women with unexplained infertility. Aberrant reproductive immunology such as decreased maternal immune tolerance towards the embryo may also be a possible explanation. However, a growing body of evidence suggests that epigenetic modifications in sperm may be partially responsible.
In India up to 25% of infertile couples have unexplained infertility.
Potential methods in unexplained infertility include oral ovarian stimulation agents as well as intrauterine insemination (IUI), intracervical insemination (ICI) and in vitro fertilization (IVF).
In women who have not had previous treatment, ovarian stimulation combined with IUI achieves approximately the same live birth rate as IVF.
On the other hand, in women who have had previous unsuccessful treatment, IVF achieves a live birth rate approximately 2-3 times greater than ovarian stimulation combined with IUI.
IUI and ICI has higher pregnancy rates when combined with ovarian stimulation in couples with unexplained infertility, for IUI being 13% unstimulated and 15% stimulated, and for ICI being 8% unstimulated and 15% stimulated. However, the rate of twin birth increases substantially with IUI or ICI combined with ovarian stimulation, for IUI being 6% unstimulated and 23% stimulated, and for ICI being 6% unstimulated and 23% stimulated.
According to oral ovarian stimulation agents should not be given to women with unexplained infertility. Rather, it is recommended that in vitro fertilization should be offered to women with unexplained infertility when they have not conceived after 2 years of regular unprotected sexual intercourse. IVF avails for embryo transfer of the appropriate number of embryos to give good chances of pregnancy with minimal risk of multiple birth.
A review of randomized studies came to the result that IVF in couples with a high chance of natural conception, as compared to IUI/ICI with or without ovarian stimulation, was more effective in three studies and less effective in two studies.
There is no evidence for an increased risk of ovarian hyperstimulation syndrome (OHSS) with IVF when compared with ovarian stimulation combined with IUI.
Prognosis in unexplained infertility depends on many factors, but can roughly be estimated by e.g. the Hunault model, which takes into account female age, duration of infertility/subfertility, infertility/subfertility being primary or secondary, percentage of motile sperm and being referred by a gynecologist, sexual medicine specialist or an infertility specialist.
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