Creatine as a Promising Component of Paternal Preconception Diet

Abstract

Male fertility has been declining globally over the past several decades, advancing from a personal issue to a public health problem. Beyond any doubt, a reduction in fertility (often characterized by low sperm count or motility) can severely threaten reproductive health and lifecourse framework in a long-term fashion. Aside from uncovering the currently unknown etiology of modern-day male infertility, the scientific and medical community faces a double burden: finding an efficient biomarker of impaired fertility and exploring any intervention that can act to enhance fertility. A plethora of nutritional compounds have been recognized as possible modulators of semen quality, and specific dietary patterns and nutrients appear to be accompanied by a lower risk of male infertility. Creatine, a conditionally essential nutrient, has caught attention as a male fertility-promoting candidate due to its role in sperm energy metabolism. This mini-review describes the creatine-related bioenergetics of spermatozoa, explores a connection between creatine levels and sperm quality in men, and critically examines available evidence for interventional studies with creatine to affect sperm viability.

Keywords: creatine; creatine kinase; energy metabolism; fertility; nutrition.

Figure 1

Creatine–phosphocreatine (PCR) shuttle and high-phospate energy (E) production and utilization in spermatozoa. Abbreviations: ATP, adenosine triphosphate; ADP, adenosine diphosphate; CK, creatine kinase; MiMi-CK, mitochondrial CK isoform confined to the midpiece region rich in mitochondria; BB-CK, tail-specific CK isoform localized within the sperm tail but not in the head portion.