*Zinc: Zinc works as a co-factor for some enzymes which contain the main role for ant oxidation reactions (super oxide dismutase enzymes; SOD). For low motility and preventing sperm DNA damage, zinc for this reason is important.
*Selenium: Selenium will have more effect especially if it is being used in combination with N Acetyl Cysteine or vitamin E. Daily recommended dosage is 200 microgram.
*Vitamin E: Daily recommended dosage for vitamin E is 400 mg. Especially for low motility and low count it should be used to help improve. In combination with selenium (especially for motility) and vitamin C (especially for preventing DNA damage) also helps.
*Vitamin C: helps for motility and preventing DNA damage. Daily dosage can be 200-1000 mg.
*Carnitine: It supplies energy for sperm and may improve motility.
*Arginine: It can help to increase the motility and the vitality of the sperm.
*Folic acid: Folic acid does not make any important improvement on sperm parameters but it can help the prevention of DNA damage from some oxidation reaction.
*Glutathione: Glutathione is a strong antioxidant and can help increase the motility.
*Co enzyme Q10: The active form of co-enzyme-Q10 is Ubiquinol. 200 mg Daily intake of ubiquinol helps increase motility.
As we see very clearly the antioxidants mainly affect the motility of the sperm and they also support sperm DNA damage against the oxidation reactions so the fragmentation rate of DNA/genetic material may decrease which helps for better fertilisation and embryo quality. Combination of these antioxidants enhances the effect.
It is also very important how long they should be taken prior to an IVF treatment. It is mostly recommended to start taking these supplements at least 2 months before starting the treatment.
Less Known Two Antioxidants which may be beneficial for both male and female infertility are Guaifenesin (Muconex) and N acetyl cysteine (NAC)
Guaifenesin (Muconex brand named) is an expectorant agent which works by thinning mucus that blocks the airway due to lung or throat infections/disorders. Investigation has shown it can help to thin the cervical mucus to allow for the sperm to reach the upper female genital tract and makes conceiving easier. Also for semen parameters (especially for motility) it can also help. There are very few publications/case report showing it is beneficial. The Daily dosage of muconex is mainly 600 mg in the studies.
Acetyl Cysteine (or N Acetyl Cysteine; NAC) is a mucolytic and also a very well-known anti inti-inflammatory and antioxidant agent which is widely used for long time in medicine (acetaminophen toxicity, inflammatory diseases, lung diseases, cancer treatment etc.). It increases intracellular glutathione (GSH) levels which is the most crucial for cellular redox imbalance. Using of NAC has an important role on male fertility. It is a powerful antioxidant and also prevent germ cells from apoptosis (cell dying). It has been shown that NAC prevents the sperm’s DNA from oxidation damage. Also some studies show NAC and selenium combination may improve the motility of the sperm.