Complementary and Alternative Treatments
for Idiopathic Male Infertility

Article by Michael J. Altamura, M.D., F.A.C.S.

Infertility is defined as the inability to conceive after one year of unprotected intercourse. It affects approximately 15% of American couples and a male factor is involved in about 50% of the cases.

The causes of male infertility include:

• Endocrine
• Genetic
• Obstruction
• Varicocele
• Miscellaneous including drug therapy, chemotherapy, systemic illnesses
• Idiopathic male infertility in which no cause can be identified to explain the reason for the abnormal semen parameters

This last group includes 25% of male infertility cases. These patients have been treated empirically with a number of different drugs. Clomiphene, the most commonly used agent, has not proven to be any more effective than placebo. Furthermore, the results from all of the drugs used have been largely inconsistent. The reason for the significant variability in success rate is clear. As long as the underlying cause for these patients' infertility remains undetermined, it follows that specific treatment for this category of patients cannot be established.

In recent decades, some researchers have studied oxidative stress and antioxidant therapy in men with infertility. Oxidative stress results when there is an imbalance between oxidants (also called free radicals and reactive oxygen species are chemicals that cause oxidation of body tissues resulting in body tissue damage) and antioxidants (chemicals that neutralize and thus eliminate oxidants from the body); more specifically, oxidative stress occurs when the total antioxidant capacity is insufficient to neutralize the oxidants present in the body. A number of studies have demonstrated an increase in reactive oxygen species in men with infertility. Other studies have shown a decrease in seminal plasma antioxidant activity. In 1997, Ilter Alkan et al. studied the production of reactive oxygen species by spermatozoa of patients with idiopathic infertility and the relationship to seminal plasma antioxidants. They found decreased seminal plasma antioxidant activity and increased reactive oxygen species level in men with idiopathic male infertility. Whether there is an increase in the production of reactive oxygen species or a reduction in the antioxidant level, the end result is the same--the presence of an abnormal level of reactive oxygen species which causes damage to the sperms.

If idiopathic male infertility is caused primarily by an insufficiency of the plasma antioxidant system to neutralize the oxidants being produced then therapy with antioxidant supplementation should yield good results in men who are diagnosed with idiopathic male infertility. In fact, clinical studies have been carried out treating male infertility with various antioxidants and the results have been promising. Dr. Altamura is now offering men with idiopathic infertility the option of using combination antioxidant therapy before considering assisted reproductive techniques.