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Do supplements improve sperm count?

Probably not much. In the largest trial, folic acid plus zinc taken for 6 months by 2,370 men did not raise sperm counts or live births, and a 7-ingredient antioxidant pill did no better than placebo in 174 men with poor semen tests. Smaller CoQ10 trials look more hopeful, but that evidence is weak. Grade B. A urologist visit to look for treatable causes comes first.

Last reviewed

How we grade evidenceEditorial policy

What the studies found

  • Grade B. Folic acid and zinc: no benefit in the biggest trial. Men in 2,370 couples planning fertility treatment took 5 mg of folic acid and 30 mg of zinc a day, or placebo, for 6 months. Sperm counts, movement and shape did not differ, live births were 34% versus 35%, and sperm DNA damage was slightly higher on the supplement. (Schisterman 2020)
  • Grade B. Antioxidant mixes: no clear benefit in the best trials. In 174 men with low counts, poor movement or high DNA damage, a daily pill of vitamins C and E, selenium, L-carnitine, zinc, folic acid and lycopene for 3 to 6 months did not improve semen or DNA, and live births did not differ. A Cochrane review found antioxidants might raise live births (12 trials, 1,283 men), but at very low certainty, and the gain vanished when trials at high risk of bias were dropped. (Steiner 2020; de Ligny 2022)
  • Grade C. CoQ10: some gain in sperm numbers, unclear for babies. A 2026 review of CoQ10 trials in men with unexplained infertility found higher sperm concentration and movement and more pregnancies. A 2025 review found CoQ10 helped movement only, no supplement raised pregnancies or live births, and the evidence was low or very low quality. (Bakri 2026; Michaelsen 2025)
  • Grade D. Date palm pollen: one study of 40 infertile men taking pollen capsules for 2 months reported better counts, but it had no placebo or comparison group. (Rasekh 2015)

Who should be careful

  • Adult upper limits are 40 mg a day for zinc (NIH ODS) and 1,000 mcg for folic acid from supplements and fortified foods (NIH ODS). The trial's folic acid dose was 5 times that limit.
  • Stomach pain, nausea and vomiting were more common with folic acid and zinc than with placebo (Schisterman 2020).
  • Zinc cuts absorption of quinolone and tetracycline antibiotics; take the antibiotic at least 2 hours before or 4 to 6 hours after zinc (NIH ODS). CoQ10 may interact with warfarin and insulin (NCCIH).
  • Testosterone treatment and anabolic steroids shut down sperm production (Crosnoe 2013). If you want children, raise this with your doctor; don't stop or change a prescribed medicine on your own.
  • See a doctor soon for a lump, swelling or pain in a testicle.
  • If you are under 18, ask a clinician first.

Try first

  • See a urologist. Treating a varicocele (swollen veins in the scrotum) may raise pregnancy rates (13 trials, 1,193 men, low certainty), though its effect on live births is uncertain (Persad 2021).
  • Stop smoking. In studies of men seen at fertility and urology clinics, smokers had lower sperm counts and poorer movement and shape (Sharma 2016).
  • Aim for a healthy weight. Obesity was linked to higher odds of a low or zero sperm count; whether losing weight restores counts is not yet known (Sermondade 2013).

Sources

  1. Schisterman EF, et al. Effect of Folic Acid and Zinc Supplementation in Men on Semen Quality and Live Birth Among Couples Undergoing Infertility Treatment: A Randomized Clinical Trial. JAMA. 2020. PubMed 31910279 · doi:10.1001/jama.2019.18714
  2. Steiner AZ, et al. The effect of antioxidants on male factor infertility: the Males, Antioxidants, and Infertility (MOXI) randomized clinical trial. Fertil Steril. 2020. PubMed 32111479 · doi:10.1016/j.fertnstert.2019.11.008
  3. de Ligny W, et al. Antioxidants for male subfertility. Cochrane Database Syst Rev. 2022. PubMed 35506389 · doi:10.1002/14651858.CD007411.pub5
  4. Bakri S, et al. Efficacy and Safety of Coenzyme Q10 in Idiopathic Male Infertility: A Systematic Review and Meta-Analysis of Randomized Trials. World J Mens Health. 2026. PubMed 40878114 · doi:10.5534/wjmh.250159
  5. Michaelsen MP, et al. The Effect of Dietary Supplements on Male Infertility in Terms of Pregnancy, Live Birth, and Sperm Parameters: A Systematic Review and Meta-Analysis. Nutrients. 2025. PubMed 40431450 · doi:10.3390/nu17101710
  6. Rasekh A, et al. Effect of Palm Pollen on Sperm Parameters of Infertile Man. Pak J Biol Sci. 2015. PubMed 26506651 · doi:10.3923/pjbs.2015.196.199
  7. Crosnoe LE, et al. Exogenous testosterone: a preventable cause of male infertility. Transl Androl Urol. 2013. PubMed 26813847 · doi:10.3978/j.issn.2223-4683.2013.06.01
  8. Persad E, et al. Surgical or radiological treatment for varicoceles in subfertile men. Cochrane Database Syst Rev. 2021. PubMed 33890288 · doi:10.1002/14651858.CD000479.pub6
  9. Sharma R, et al. Cigarette Smoking and Semen Quality: A New Meta-analysis Examining the Effect of the 2010 World Health Organization Laboratory Methods for the Examination of Human Semen. Eur Urol. 2016. PubMed 27113031 · doi:10.1016/j.eururo.2016.04.010
  10. Sermondade N, et al. BMI in relation to sperm count: an updated systematic review and collaborative meta-analysis. Hum Reprod Update. 2013. PubMed 23242914 · doi:10.1093/humupd/dms050