Probiotic-Prebiotic Combination Improves Sperm Quality

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Probiotic-prebiotic combination improves sperm quality

Synbiotic (FamiLact) administration in idiopathic male infertility enhances sperm quality, DNA integrity, and chromatin status: A triple-blinded randomized clinical trial

A triple-blinded randomized placebo-controlled trial was carried out to assess the effect of synbiotics (probiotic + prebiotic) administration on males diagnosed with idiopathic infertility (unknown cause).

The synbiotic chosen for this study was FamiLact which contains a broad spectrum of Lactobacillus strains, including Lactobacillus rhamnosus / casei / bulgaricus / acidophilus, Bifidobacterium breve / longum, Streptococcus thermophilus (109 CFU), with fructooligosaccharides as the prebiotic.

Male partners from infertile couples, referred to the Imam Reza Hospital for further treatment, were assessed for inclusion in the study. Specifically only males diagnosed with oligozoospermia, teratozoospermia and/or asthenozoospermia, but excluding the following list were allowed to participate.

Exclusion criteria
– Cryptorchidis
– Varicocele
– Chromosome abnormalities
– Leukocytospermia
– Epididymal-orchitis
– Genitourinary traumas
– Prostatitis
– Testicular torsion
– Inguinal/genital surgery
– Hormone therapy
– Endocrinopathies
– Sexually transmitted infections
– Cytotoxic drugs, immunosuppressants, anticonvulsants, androgens

In total, 56 males were randomly allocated among the 2 groups. In the treatment group, participants were given 500mg capsules (FamiLact) to take one per day, for a total of 80 days, while control group participants were given an identical placebo to take similarly.

For analysis, semen samples were collected before and after the trial period following 2-7 days of sexual abstinence. Sperm concentration was calculated using the Sperm Counting Chamber (Shivani Scientific Industries, India) while motility was assessed by Computer-Assisted Sperm Analysis. Lipid peroxidation, protamine deficiency and DNA fragmentation were also measured to thoroughly evaluate any changes.

At the end of the trial, seven participants were lost to follow-up. Final study population was 22 males in the treatment group and 25 controls.

Baseline sperm characteristics including volume, concentration, motility and abnormal morphology) before trial was not significantly different among the 2 groups.

Interestingly, post-trial semen analysis showed significantly increased concentration (44.1 ±24.97 vs 28.85 ±17.1 M/mL), motility (50.81 ±34.94 vs 38.4 ±25.08 %) and normal sperm morphology in the treatment group, while no significant changes were seen in the control group, other than a statistically insignificant increase in concentration (21.54 ±15.48 to 27.98 ± 17.42, P=0.06).

In other testing, sperm lipid peroxidation, CMA3 positivity and DNA fragmentation index was not different between the 2 groups pre-trial, however following treatment, sperm lipid peroxidation (26 ±18.82 vs 29.53 ±19.4 %) and DNA fragmentation index (25.19 ±7.22 vs 28.81 ±13.27 %) significantly improved in the treatment group.

However similar improvements were also seen in the placebo controlled group, sperm lipid peroxidation (24.72 ±15.91 vs 26.32 ±15.35 %) and DNA fragmentation index (25.32 ±6.66 vs 26.75 ±10.54 %) making these specific improvements (sperm lipid peroxidation, CMA3 positivity and DNA fragmentation index) statistically insignificant (P > 0.27) between the two 2 groups.

In the concluding remarks, the authors hypothesize that improvements in oxidative stress is most likely responsible for these results, given that the protamine content of sperm chromatin (CMA3 positivity) did not change while DNA fragmentation levels decreased.


In this triple-blinded randomized placebo controlled trial, 500mg daily of probiotics combined with prebiotics (Synbiotics) supplementation for 80 days significantly increased sperm count, concentration (44.1 vs. 28.85 106/mL), motility (50.81 vs. 38.4 %) and normal morphology in the treatment group.


  1. Small study size

Similar studies

Dardmeh F, et al. (2017). Lactobacillus rhamnosus PB01 (DSM 14870) supplementation affects markers of sperm kinematic parameters in a diet-induced obesity mice model.

Maretti C and Cavallini G, (2017). The association of a probiotic with a prebiotic (Flortec, Bracco) to improve the quality/quantity of spermatozoa in infertile patients with idiopathic oligoasthenoteratospermia: a pilot study.

Valcarce D G, et al. (2017). Probiotic administration improves sperm quality in asthenozoospermic human donors.

Wang B G, et al. (2016). Efficacy of oral Bifidobacterium bifidum ATCC 29521 on microflora and antioxidant in mice.


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