Iranian Society of Gynecology Oncology


1 Department of Obstetrics and Gynocology, Iran University of Medical Sciences, Tehran, IR Iran

2 Department of Community Medicine, Iran University of Medical Sciences, Tehran, IR Iran


Background: Different studies found that zinc is necessary for sexual maturity, growth and fertility. But there are no distinct studies that clarify the role of zinc supplements on semen parameters.

Objectives: The current study aimed to evaluate the zinc supplement therapeutic effects on semen samples of infertile males. Patients and Methods: The study comprised one-hundred-twenty sub fertile males. The study was a double-blinded placebo controlled clinical trial. The subjects were randomly allocated to treatment with zinc supplement (n = 60) or placebo (n = 60) groups. Subjects in both groups were given 10 mL, three times daily. In order to determine the sperm concentration, Motility and morphology, standardized semen and blood samples were obtained before and after treatment, according to the World Health Organization (WHO) guidelines; semen morphology according to strict criteria, and blood and semen zinc concentration also were measured. Effects of the two interventions were evaluated in sub fertile males.
Results: Sub fertile males demonstrated a significant increase (8.8 ± 7.4 × 106 cells/mL to 17.2 ± 13.5 × 106 cells/mL) in concentration and normal sperm in zinc group versus the placebo group. Blood serum zinc concentration increased in the interventional group significantly (P = 0.000), and also semen plasma zinc concentration increased significantly (P = 0.000).
Conclusions: Normal sperm percentage and total sperm concentration increased after zinc sulfate treatment. The beneficial effect of zinc and all results of the current study opened new way to medical purposes and public health researches.


  1. Auger J, Kunstmann JM, Czyglik F, Jouannet P. Decline in semen quality among fertile men in Paris during the past 20 years. N Engl J Med. 1995;332(5):281-5. [DOI:10.1056/NEJM199502023320501]
  2. Irvine S, Cawood E, Richardson D, MacDonald E, Aitken J. Evidence of deteriorating semen quality in the United Kingdom: birth cohort study in 577 men in Scotland over 11 years. BMJ. 1996;312(7029):467-71. [DOI:10.1136/bmj.312.7029.467]
  3. Skakkebaek NE, Giwercman A, de Kretser D. Pathogenesis and management of male infertility. Lancet. 1994;343(8911):1473-9. [DOI:10.1016/S0140-6736(94)92586-0]
  4. Kuroki Y, Iwamoto T, Lee J, Yoshiike M, Nozawa S, Nishida T, et al. Spermatogenic ability is different among males in different Y chromosome lineage. J Hum Genet. 1999;44(5):289-92. [DOI:10.1007/s100380050162]
  5. van Pelt AM, de Rooij DG. Retinoic acid is able to reinitiate spermatogenesis in vitamin A-deficient rats and high replicate doses support the full development of spermatogenic cells. Endocrinology. 1991;128(2):697-704. doi: 10.1210/endo-128-2-697. [DOI:10.1210/endo-128-2-697]
  6. Ciereszko A, Dabrowski K. Sperm quality and ascorbic acid concentration in rainbow trout semen are affected by dietary vitamin C: anacross-season study. Biol Reprod. 1995;52(5):982-8. [DOI:10.1095/biolreprod52.5.982]
  7. Gregory J, Foster K, Tyler H, Wiseman M. The dietary and nutritional survey of British adults.. London: HMSO; 1990.
  8. de Bree A, van Dusseldorp M, Brouwer IA, van het Hof KH, Steegers Theunissen RP. Folate intake in Europe: recommended, actual and desired intake. Eur J Clin Nutr. 1997;51(10):643-60. [DOI:10.1038/sj.ejcn.1600467]
  9. Favier AE. The role of zinc in reproduction. Hormonal mechanisms.Biol Trace Elem Res. 1992;32:363-82. [DOI:10.1007/BF02784623]
  10. Galdes A, Vallee BL. Categories of zinc metalloenzymes. 1. New York: Dekker; 1983.
  11. Freedman LP. Anatomy of the steroid receptor zinc finger region. Endocr Rev. 1992;13(2):129-45. doi: 10.1210/edrv-13-2-129. [DOI:10.1210/edrv-13-2-129]
  12. Menkveld R, Wong WY, Lombard CJ, Wetzels AM, Thomas CM, Merkus HM, et al. Semen parameters, including WHO and strict criteria morphology, in a fertile and subfertile population: an effort towards standardization of in-vivo thresholds. Hum Reprod. 2001;16(6):1165-71. [DOI:10.1093/humrep/16.6.1165]
  13. World Health Organization . Laboratory manual for the examination of human semen and semen-cervical mucus interaction. Cambridge (UK): Cambridge University Press; 1992.
  14. Menkveld R, Stander FS, Kotze TJ, Kruger TF, van Zyl JA. The evaluation of morphological characteristics of human spermatozoa according to stricter criteria. Hum Reprod. 1990;5(5):586-92. [DOI:10.1093/oxfordjournals.humrep.a137150]
  15. Dony JM, Smals AG, Rolland R, Fauser BC, Thomas CM. Effect of aromatase inhibition by delta 1-testolactone on basal and luteinizing hormone-releasing hormone-stimulated pituitary and gonadal hormonal function in oligospermic men. Fertil Steril. 1985;43(5):787-92. [DOI:10.1016/S0015-0282(16)48567-5]
  16. Hartoma TR, Nahoul K, Netter A. Zinc, plasma androgens and male sterility. Lancet. 1977;2(8048):1125-6. [DOI:10.1016/S0140-6736(77)90563-3]
  17. Tikkiwal M, Ajmera RL, Mathur NK. Effect of zinc administration on seminal zinc and fertility of oligospermic males. Indian J Physiol Pharmacol. 1987;31(1):30-4.
  18. Landau B, Singer R, Klein T, Segenreich E. Folic acid levels in blood and seminal plasma of normo- and oligospermic patients prior and following folic acid treatment. Experientia. 1978;34(10):1301-2. [DOI:10.1007/BF01981432]
  19. Ghishan FK, Said HM, Wilson PC, Murrell JE, Greene HL. Intestinal transport of zinc and folic acid: a mutual inhibitory effect. Am J Clin Nutr. 1986;43(2):258-62. [DOI:10.1093/ajcn/43.2.258]
  20. Quinn PB, Cremin FM, O'Sullivan VR, Hewedi FM, Bond RJ. The influence of dietary folate supplementation on the incidence of teratogenesis in zinc-deficient rats. Br J Nutr. 1990;64(1):233-43. [DOI:10.1079/BJN19900025]
  21. Favier M, Faure P, Roussel AM, Coudray C, Blache D, Favier A. Zinc deficiency and dietary folate metabolism in pregnant rats. J Trace Elem Electrolytes Health Dis. 1993;7(1):19-24.
  22. Wong WY, Thomas CMG, Merkus JMWM, Zielhuis GA, Steegers Theunissen RPM. Male factor subfertility: possible causes and the impact of nutritional factors. Fertil Steril. 2000;73:435-42. [DOI:10.1016/S0015-0282(99)00551-8]
  23. Chia SE, Ong CN, Chua LH, Ho LM, Tay SK. Comparison of zinc concentrations in blood and seminal plasma and the various sperm parameters between fertile and infertile men. J Androl. 2000;21(1):53-7.
  24. 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. FertilSteril. 2002;77(3):491-8. [DOI:10.1016/S0015-0282(01)03229-0]
  25. Tielemans E, Heederik D, Burdorf A, Loomis D, Habbema DF. Intraindividual variability and redundancy of semen parameters. Epidemiology. 1997;8(1):99-103. [DOI:10.1097/00001648-199701000-00016]
  26. Neuwinger J, Behre HM, Nieschlag E. External quality control in the andrology laboratory: an experimental multicenter trial. Fertil Steril. 1990;54:308-14. [DOI:10.1016/S0015-0282(16)53709-1]
  27. Colagar AH, Marzony ET, Chalchi MJ . The role of antioxidant therapy in the treatment of male infertility. Human Fertil. 2010;13(4):217-25. [DOI:10.3109/14647273.2010.532279]
  28. Ashok A, Sekhon LH. Oxidative stress and antioxidants for idiopathic oligoasthenoteratospermia: Is it justified?. Indian J Urolog. 2011;27(1):74. [DOI:10.4103/0970-1591.78437]
  29. Zanaty S, Malm J, Giwercman A. Visco-elasticity of seminal fluid in relation to the epididymal and accessory sex gland function and its impact on sperm motility. Int J Androl. 2004;27(2):94-100. [DOI:10.1046/j.1365-2605.2003.00455.x]
  30. Zhou J, Chen L, Li J, Li H, Hong Z, Xie M, et al. The Semen pH Affects Sperm Motility and Capacitation. PLoS One. 2015;10(7):e0132974. [DOI:10.1371/journal.pone.0132974]