Micronutrients

Folic acid for men: Effect on fertility

from Dr. Michael Kohlberger, BSc, MSc
on 24.06.2024
Man taking folic acid

Folic acid is known to many as an important nutrient for women who wish to have children and for women who are pregnant. The B vitamin plays a crucial role in the healthy development of the embryo. An aqdequate folic acid supply can also be beneficial for men – especially if they wish to have children.

Although folic acid is often associated with female health, recent studies show that this nutrient can also positively affect male fertility. In our article, we go into more detail about the importance of folic acid for men.

What does folic acid deficiency mean in men?

A folic acid deficiency in men can have a variety of negative effects, just like in women. Possible physical symptoms include anaemia, pale skin and mucous membranes, increased bleeding tendency, susceptibility to infection, loss of appetite and weight loss, gastrointestinal problems and an increased risk of cardiovascular diseases.

The following symptoms may occur on a neurological and psychological level: Irritability, mood swings, increased risk of depression, fatigue and insomnia as well as concentration disorders.

Overall, this illustrates the importance of an adequate folic acid supply for men’s health.

All about folic acid deficiency

Reduce the risk of birth defects with folic acid

Folic acid is very important for expectant mothers, as this B vitamin can significantly reduce the risk of neural tube defects such as spina bifida in the unborn child. For this reason, women wishing to have children are recommended to take increased amounts of folic acid, ideally before pregnancy and in the first weeks after conception.

All information about folic acid during pregnancy

Some media reports now also suggest a potential benefit of folic acid for fathers to be. This is based on a recent study in mice, which showed that folic acid deficiency in male rodents was associated with more birth defects in the offspring. However, results from animal experiments cannot be readily transferred to humans. In addition, the folic acid deficiency in the study may have already occurred during the development of the experimental animals itself and may be less related to their later diet. There are no conclusive studies to prove a connection between paternal folic acid deficiency and birth defects in humans.

Improve fertility with folic acid

However, there is evidence that folic acid can have a positive effect on sperm quality and sperm count in men, but the current study situation is still limited and the results are not clear.

Some smaller studies have shown that the intake of folic acid supplements in men with fertility problems can lead to an increase in sperm concentration and an improvement in certain sperm properties such as motility* and morphology**. There is also evidence that folic acid can positively influence the general sperm quality – the combination with zinc, known as the “men’s mineral”, seems particularly positive. Thus, in men with a sufficient folic acid intake, fewer sperm cells had genetic defects and damage to the genetic material than in subjects with a folic acid deficiency. A balanced supply of this B vitamin could thus promote cellular integrity*** and the functioning of male gametes. However, it remains to be clarified whether these effects are pronounced enough to significantly increase the chances of pregnancy.

Larger studies with higher significance on the fertility promoting effects of folic acid in men are still required. The existing data suggests that folic acid could potentially have a positive effect on various sperm health parameters.

What is sperm quality?

The sperm quality refers to various parameters that describe the quality and functionality of the sperm. It is mainly concerns their number, mobility and speed.

The most important criteria for good sperm quality are:

  • sperm concentration – the number of sperm per millilitre of semen. Normal values are over 15 million/ml.
  • *Sperm motility – the motility and buoyancy of the sperm. The more mobile, the better they can reach the egg.
  • **Sperm morphology – the normal oval shape and structure of sperm without form defects.
  • Vitality – the proportion of living, intact sperm without cell damage.
  • ***DNA integrity – the genetic material of the sperm should be as undamaged as possible for healthy fertilisation.

Risk in the case of reduced sperm quality

Inadequate folic acid intake can have a detrimental effect on the chromosome integrity of the sperm. A study by the University of Berkeley came to this conclusion.

The scientists found that sperm from men with a poor folic acid supply were more likely to exhibit abnormalities in the correct number and structure of the chromosomes. However, such chromosomal deviations can lead to serious complications such as Down’s syndrome or miscarriage in the event of fertilisation.

An intact chromosome base is an important factor for normal sperm quality. Chromosome defects are considered one of the most common reasons for fertility problems in men. The study results suggest that folic acid deficiency could increase the risk of such genetic damage to sperm cells and thus impair fertility.

What is a spermiogram?

In order to be able to assess the sperm quality and quantity, a spermiogram is necessary. A spermiogram is a test of male semen (sperm). The following parameters are analysed in a spermiogram:

  • Semen volume
  • Sperm concentration (number of sperm per ml)
  • Sperm motility (movement of sperm)
  • Sperm morphology (form and structure of sperm)
  • pH and viscosity of the semen
  • Percentage of live/dead sperm
  • Possible additional parameters such as number of leukocytes, etc.

The spermiogram provides important indications of possible fertility disorders in men. It is often one of the first examination steps when couples have problems becoming pregnant. The results provide indications for further clarifications and possible treatment. However, an unremarkable spermiogram does not exclude fertility disorders, since other factors can also play a role.

Tips for improving sperm quality

  •           Healthy diet: A balanced, nutrient-rich diet full of fruit, vegetables, whole grains, nuts and fish can promote sperm quality. Also make sure you take enough time for your meals.
  • Normal weight: Overweight and obesity can have a negative impact on sperm production. A body mass index (BMI) in the normal range is to be aimed for.
  • Exercise and sport: Regular moderate exercise improves circulation and prevents obesity – both of which promote spermiogenesis.
  • Stress reduction: Chronic stress can affect sperm quality.
  • Avoid smoking and alcohol: Smoking and excessive alcohol consumption have been shown to damage sperm production.
  • Cool environment: Persistent overheating of the scrotal area damages the sperm. Tight underwear and long saunas should therefore be avoided.
  • Sufficient sleep: Restful sleep promotes healthy hormone production, which can have a positive effect on sperm.
  • Food supplements: Targeted supplementation by taking food supplements with vitamins and nutrients such as zinc, selenium, coenzyme Q10 and folic acid can be useful in some cases.
More tips on becoming pregnant
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Further Reading:

De-Regil LM, Peña-Rosas JP, Fernández-Gaxiola AC, Rayco-Solon P. Effects and safety of periconceptional oral folate supplementation for preventing birth defects. Cochrane Database of Systematic Reviews 2015, Issue 12. Art. No.: CD007950.

Lambrot R, Xu C, Saint-Phar S, Chountalos G, Cohen T, Paquet M, Suderman M, Hallett M, Kimmins S. Low paternal dietary folate alters the mouse sperm epigenome and is associated with negative pregnancy outcomes. Nat Commun. 2013 Dec 10;4:2889.

Azizollahi G, Azizollahi S, Babaei H, Kianinejad M, Baneshi MR, Nematollahi-mahani SN. Effects of supplement therapy on sperm parameters, protamine content and acrosomal integrity of varicocelectomized subjects. J Assist Reprod Genet. 2013 Apr;30(4):593-9.

Ebisch IM, Thomas CM, Peters WH, Braat DD, Steegers-Theunissen RP. The importance of folate, zinc and antioxidants in the pathogenesis and prevention of subfertility. Hum Reprod Update. 2007 Mar-Apr;13(2):163-74.

Wong WY, Merkus HM, Thomas CM, Menkveld R, Zielhuis GA, Steegers-Theunissen RP. Effects of folic acid and zinc sulfate on male factor subfertility: a double-blind, randomized, placebo-controlled trial. Fertil Steril. 2002 Mar;77(3):491-8.

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