A Randomized Trial to Evaluate the Effects of Folic Acid and Zinc Supplementation on Male Fertility and Livebirth: Design and Baseline Characteristics

Am J Epidemiol. 2020 Jan 31;189(1):8-26. doi: 10.1093/aje/kwz217.

Abstract

The Folic Acid and Zinc Supplementation Trial (FAZST) was a multicenter, double-blind, block-randomized, placebo-controlled trial to determine whether folic acid and zinc supplementation in men improves semen quality and increases livebirth rate among couples seeking infertility treatment (2013-2017). Eligible men were aged 18 years or older with female partners aged 18-45 years, seeking infertility treatment. Men were randomized (1:1) to 5 mg folic acid and 30 mg elemental zinc daily or matching placebo for 6 months. Randomization was stratified by site and intended infertility treatment (in vitro fertilization (IVF), non-IVF/study site, and non-IVF/outside clinic). Follow-up of men continued for 6 months, and female partners were passively followed for a minimum of 9 months. Women who conceived were followed throughout pregnancy. Overall, 2,370 men were randomized during 2013-2017 (1,185 folic acid and zinc, 1,185 placebo); they had a mean age of 33 years and body mass index (weight (kg)/height (m)2) of 29.8. Most participants were white (82%), well educated (83% with some college), and employed (72%). Participant characteristics were balanced across intervention arms. Study visits were completed by 89%, 77%, and 75% of men at months 2, 4, and 6, respectively. Here we describe the study design, recruitment, data collection, lessons learned, and baseline participant characteristics.

Keywords: folic acid; livebirth; male fertility; semen quality; supplements; zinc.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, N.I.H., Intramural

MeSH terms

  • Adolescent
  • Adult
  • Dietary Supplements*
  • Double-Blind Method
  • Female
  • Fertilization in Vitro
  • Folic Acid / administration & dosage*
  • Humans
  • Infant, Newborn
  • Infertility, Male / therapy*
  • Live Birth*
  • Male
  • Middle Aged
  • Pregnancy
  • Research Design
  • Semen Analysis
  • Treatment Outcome
  • Young Adult
  • Zinc / administration & dosage*

Substances

  • Folic Acid
  • Zinc