A Cross-sectional Study of the Relationship of Serum Folic Acid, Vitamin B12, Zinc, Magnesium with Semen Parameters in Infertile Couples in Hong Kong

Objectives: The primary objective was to evaluate the association of serum folate, vitamin B12, zinc, magnesium with semen parameters in infertile couples in Hong Kong. The secondary objective was to explore whether the study participants were deficient in any of these micronutrients. The impact of smoking on semen parameters was also analysed. Methods: This cross-sectional study recruited 196 Chinese men from the Subfertility Clinic of the Department of Obstetrics and Gynaecology, Kwong Wah Hospital between August 2012 and November 2013. Semen and blood samples were collected on the same day for analysis. Results: Higher levels of serum magnesium were significantly associated with higher percentages of normal sperm morphology (p=0.02). The median levels of micronutrients studied were within the normal range, indicating that deficiency of these nutrients was rare in our locality, although such deficiency is common in western countries. Both median semen volume and sperm concentration were within the normal range but the median percentages of normal sperm morphology and motility were below the normal range. We postulate that sperm morphology might be improved by an increased intake of magnesium. Smoking was significantly associated with low semen volume (p=0.01). Conclusion: This is the first study to evaluate the relationship between serum micronutrients and semen parameters in infertile Chinese couples in our locality. Male subfertility is a multifactorial disorder. Although both nutritional and lifestyle factors are important and modifiable, further research on these subjects would provide a platform for potential fertility treatments.