FOLIC ACID AND ZINC SUPPLEMENTATION TREATMENT (FAZST)

Infertility affects 10 to 15% of couples attempting to conceive. Male factor subfertility plays a role in about 50% of subfertile couples, with largely unknown etiology. An intervention with even a small absolute effect on any component of male factor infertility has implications at the population level because of the large potential attributable benefit. Two micronutrients fundamental to the process of spermatogenesis, folic acid and zinc, are of particular interest as they are low cost and widely available. Though the evidence has been inconsistent, small, randomized trials and observational studies show that folate and zinc have biologically plausible effects on spermatogenesis and improved semen parameters. These results suggest that supplementation with folate and zinc may improve semen quality and assisted reproductive technology outcomes. While dietary supplements marketed for male fertility commonly contain folic acid and zinc based on limited prior evidence for improving semen quality, no large-scale trial has examined the efficacy of this therapy for improving semen quality or live birth. The primary objective of the FAZST study is to assess the efficacy in males of folic acid and zinc supplementation on semen quality and live birth rate) among couples seeking fertility treatment.