ArticlePDF Available

Randomized Clinical Trial: Effect of Walnuts on Semen Parameters and Male Fertility (P18-042-19)

June 2019
Current Developments in Nutrition 3(Supplement_1)

DOI:10.1093/cdn/nzz039.P18-042-19

License
CC BY-NC-ND 4.0

Authors:

Justin Houman

Cedars-Sinai Medical Center

Geng-Wei Lee

University of California, Los Angeles

Objectives: Infertility affects ∼8-12% of couples worldwide with ∼40% attributed to male factors. Recent studies suggest a role for paternal diet in fertility. Walnuts contain a variety of nutrients essential in the development of spermatozoa. We conducted a randomized clinical trial (RCT) to determine if consumption of walnuts improves semen parameters and fertility in men seeking clinical care for male factor infertility. Methods: This was a two arm, single blind, RCT. The comparison groups both received usual care for male factor infertility. One group added 42 gm/d walnuts to their diet, and the other group added a daily nutritional supplement recommended for male reproductive health. Participants (n = 75) were enrolled at an infertility clinic located in a large metropolitan medical center. Eligibility was determined by history, physical exam, and lab tests collected as part of clinical care. Research measures included semen analysis and blood sample at baseline and 3 months; ASA24 dietary recall at baseline, 2 and 3 months; and fertility report at 3 months and 1 year. Results: Age range was 27 to 61 years (39.7 ± 7.0); BMI range 19.6 to 46.9 (26.8 ± 4.5); participant race was Asian 26.2%, White 44.3%, Hispanic White 16.4%, Black 8.2%, other 4.9%. Baseline sperm concentration was 39.4 ± 30 million per ml; sperm motility 31.1 ± 23.4%; and progressive motility 21.2 ± 15.8%. At 3 months, the walnut group demonstrated increased sperm motility and concentration, P = .04 and P = .07, respectively, whereas no significant changes from baseline were found in the nutritional supplement group. Both groups showed improved sperm morphology, P < .03. Preliminary data from the subset of men with 1-year follow-up data shows higher frequency of pregnancy in the walnut group compared to nutritional supplement, although not statistically significant, P = .09. We continue to follow the remaining participants until their 1-year fertility report. Conclusions: This RCT demonstrated a beneficial effect of adding walnuts to the diet on sperm motility and morphology in men seeking care for infertility. Preliminary fertility data suggests walnuts may enhance the probability of pregnancy for men with male factor infertility. Funding sources: Center for Occupational and Environmental Health, University of California, Los Angeles; California Walnut Commission.

Available via license: CC BY-NC-ND 4.0

Content may be subject to copyright.

Nutritional Epidemiology 1587

Randomized Clinical Trial: Eect of Walnuts on Semen Parame-

ters and Male Fertility (P18-042-19)

Wendie Robbins,1Howard Kim,2Justin Houman,2and Geng-

Wei Le e 1

1University of California Los Angeles and 2Cedars-Sinai Medical

Center

Objectives: Infertility aects ∼8–12% of couples worldwide with

∼40% attributed to male factors. Recent studies suggest a role for

paternal diet in fertility. Walnuts contain a variety of nutrients essential

in the development of spermatozoa. We conducted a randomized

clinical trial (RCT) to determine if consumption of walnuts improves

semen parameters and fertility in men seeking clinical care for male

factor infertility.

Methods: This was a two arm, single blind, RCT. The comparison

groups both received usual care for male factor infertility. One group

added 42 gm/d walnuts to their diet, and the other group added a daily

nutritional supplement recommended for male reproductive health.

Participants (n=75) were enrolled at an infertility clinic located in a

large metropolitan medicalcenter. Eligibility was determined by history,

physical exam, and lab tests collected as part of clinical care. Research

measures included semen analysis and blood sample at baseline and 3

months; ASA24 dietary recall at baseline, 2 and 3 months; and fertility

reportat3monthsand1year.

Results: Agerangewas27to61years(39.7±7.0); BMI range 19.6

to 46.9 (26.8 ±4.5); participant race was Asian 26.2%, White 44.3%,

Hispanic White 16.4%, Black 8.2%, other 4.9%. Baseline sperm con-

centration was 39.4 ±30 million per ml; sperm motility 31.1 ±23.4%;

and progressive motility 21.2 ±15.8%. At 3 months, the walnut group

demonstrated increased sperm motility and concentration, P=.04 and

P=.07, respectively, whereas no signicant changes from baseline

were found in the nutritional supplement group. Both groups showed

improved sperm morphology, P<.03. Preliminary data from the subset

of men with 1-year follow-up data shows higher frequenc y of pregnancy

in the walnut group compared to nutritional supplement, although not

statistically signicant, P=.09. We continue to follow the remaining

participants until their 1-year fertility report.

Conclusions: This RCT demonstrated a benecial eect of adding

walnuts to the diet on sperm motility and morphology in men

seeking care for infertility. Preliminary fertility data suggests walnuts

may enhance the probability of pregnancy for men with male factor

infertility.

Funding Sources: Center for Occupational and Environmental

Health, University of California, Los Angeles; California Walnut

Commission.

CURRENT DEVELOPMENTS IN NUTRITION

Insights of Pharmacological Activities, Patents and Clinical Applications of Polyphenolic Compounds Enriched Nuts of Juglans regia: A Review

Article

Full-text available

Jan 2024
Indian J Pharmaceut Sci

Herbal foodstuffs in Avicenna’s recommended diet to improve sperm quality and increase male fertility; an evidence-based approach

Article

Feb 2021

Attention to diet was considered important issues in improvement of men infertility in Persian Medicine (PM). The purpose of this study was to extract herbal foodstuffs introduced by Avicenna, one of the greatest PM physicians to improve the semen production and to provide evidence of their impact on the basis of current studies.“Canon of Medicine”, the most important Avecinna's book, was searched with keywords equivalent to semen, fertility and infertility, main herbal foodstuffs were extracted and was searched with keywords sperm, semen, infertility, and fertility in Google scholar, PubMed and Scopus databases. Manuscripts from 1950 up to December 2019 were selected and reviewed. Almond, Onion, Chickpea, Garlic, Coconut, Palm date, Sesame, Fenugreek, Carrot, Fig, Grapes, Pistachio, Hazelnut and Walnut are among main foodstuffs which recommended by Avicenna and there is also evidence that they have positive effects on testosterone production and improvement of various sperm parameters, including count, motility and morphology. Containing large amount of different macro and micronutrients such as vitamins including vit B, C, A and E, minerals such as Mg, Se, Zn, Cu and Fe, important unsaturated fatty acids such as linoleic and oleic acids, amino acids such as lysine and arginine and phytochemicals such as polyphenols, flavonoids, triterpenes and steroids can be considered as a main factor in the effectiveness of these foodstuffs. Designing a diet based on the fruits, vegetables, nuts and seeds that Avicenna has recommended, may be effective in treating male infertility but further studies are needed to clarify this issue. Research on the effectiveness of his other recommended foodsuffs may also offer new treatments and supplements for this purpose.

Frequency of male factor and abnormalities of semen analysis in infertile couple.

Article

Jul 2020

Infertility is global health issue. Male factor contribute to infertility in more than half of sub fertile couples. Their diagnosis is easy by simple test of husband semen analysis. This study has been designed to know the contribution of male factor and frequency of abnormalities of semen in infertile couple. Objectives: To determine the frequency of male factor in infertile couple and to evaluate the different abnormalities in semen. Study Design: Descriptive study. Setting: Department of Obstetrics and Gynecology in Nishtar Hospital Multan. Period: From January 2019 to June 2019. Material & Methods: Study started after taking approval from hospital ethical committee. Study included 200 subfertile couples after informed consent attending the outpatient department. The partner of female attending the fertility clinic between ages 20-40 were selected. History taken from female partner regarding age, duration of subfertility, type of subfertility any drug intake and medical illness of male. Result: Among 200 couples 64(32%) had abnormal semen parameters.24 had oligospermia. Eight had azoospermia and 60 had asthenospermia. 20 patients had teratospermia. Conclusion: Male factor is significant contributor of infertility therefore awareness is needed in order to engage more males partner in evaluation and management of infertility.

Seminal parameters among patients visiting infertility clinic at the National Referral Hospital, Bhutan

Article

Full-text available

Dec 2023

Introduction: Seminal fluid analysis is the initial investigation for any couple presenting with either primary or secondary infertility. In this study, we aim to study the seminal fluid parameters among Bhutanese patients who presented at the infertility clinic for an initial seminal fluid examination. Methods: This retrospective descriptive study was conducted at the Infertility Clinic of the National Referral Hospital, Bhutan from January to December 2022. Using the census sampling technique, data on seminal parameters of 304 patients was extracted from the clinic’s register. A descriptive analysis of frequencies and percentages on the above data was performed using IBM Corp’s SPSS version 26.0, Armonk, NY). Results: The result showed that the majority 217(70.4%) of the patients who came for semen analysis were in the age range between 30 and 39 years. Among 304 patients examined, 72(23.7%) showed normal semen parameters while 232(76.3%) displayed abnormalities in their semen parameters. These abnormalities were further categorised as follows: Azoospermia 14(4.6%), Oligozoospermia 109(35.9%), Asthenozoospermia 23(7.6%) and 86(28.2%) cases were Oligoasthenozoospermia. Conclusions: This study provides a scientific data for the first time regarding seminal parameters of patients that visited infertility clinics. This data can serve as a reliable reference and valuable source of evidence for clinicians and future researchers. As the pioneering study of its kind in the country, this study generates fundamental evidence-based data for the global scientific community as well, promoting sustained research involvement in the field of reproductive medicine over the long run.

Nonpharmacological Interventions for the Management of Testosterone and Sperm Parameters: A Scoping Review

Article

Jul 2022
CLIN THER

Purpose: Testosterone replacement and associated pharmacologic agents are effective strategies to treat male hypogonadism; however, nutraceutical agents and lifestyle modification approaches have gained medical interest. The purpose of this scoping review is to highlight the evidence (or lack thereof) of nutraceuticals and lifestyle modification approaches in the management of testosterone levels and sperm parameters. Methods: A scoping review of nonpharmacologic interventions (supplements, herbal medicines, diets, sleep, and exercise) with the potential to improve male health was undertaken to elucidate changes in testosterone levels and sperm parameters in men with hypogonadism or infertility compared with healthy patients. Findings: A multitude of nutraceuticals and functional nutrients are purported to stimulate testosterone production; however, only a select few have had promising results, such as zinc, vitamin D (in case of hypovitaminosis D), l-arginine, mucuna, and ashwagandha, based on well-controlled randomized clinical trials of men with low testosterone levels and related problems. Except for l-arginine, these natural agents, as well as tribulus and ω3 fatty acids, can improve some degree of sperm parameters in infertile men. Before implementing these nutraceutical agents, adequate sleep, exercise, and weight loss in patients with obesity are imperative. The effects of nonpharmacologic interventions on testosterone levels are modest and hence do not directly translate into clinical benefits. Correspondingly, androgen receptor content, but not endogenous androgens, has been regarded as the principal factor in muscle hypertrophy. Implications: A limited number of supplements and herbal medicines can be considered as adjunctive approaches in the management of testosterone levels and sperm parameters, primarily in men with low testosterone levels and infertility, whereas most nonpharmacologic supplements appear to lack evidence. Although proper physical exercise, sleep, and diet are indisputable approaches because of the general benefits to health, the use of nutraceuticals, if considered, must be personalized by physicians and/or registered dietitians.

ResearchGate has not been able to resolve any references for this publication.