Is creatine and male fertility safe during pregnancy?

What does the evidence say about creatine and male fertility during pregnancy?

1. Sperm cells naturally contain high concentrations of creatine as part of their energy metabolism, and a cross-sectional study of 778 young men found those using creatine supplements had higher semen concentrations than non-users, 42 million per mL versus 36 million per mL. Separately, low semen creatine and high creatine kinase activity have been linked to poorer sperm quality in observational research. 1
2. A 12-week randomized controlled trial found no significant difference in DHT levels, the DHT-to-testosterone ratio, or hair growth between men taking creatine and men taking a placebo, directly contradicting the single older, smaller study that first raised the DHT concern using a shorter 3-week protocol with a loading phase. 2
3. A review covering decades of research, including protocols from 1 to 80 grams a day for up to 60 months, found no evidence that creatine supplementation impairs kidney function in healthy people. It also has not been shown to cause dehydration or cramping, and some data point the opposite way. 3
4. A small 8-week pilot trial in 15 men found creatine supplementation, with or without ubiquinol, produced only non-significant changes in sperm creatine and creatine kinase levels, underscoring that human trials measuring actual sperm count or motility outcomes are still limited. 4
5. At the standard recommended doses of 5 to 20 grams a day, creatine monohydrate is described as safe for most healthy populations, with stomach upset mainly tied to single doses above 10 grams rather than the supplement itself. 3

Is creatine and male fertility safe in each trimester?

• First trimester. If you're just starting to try and already take creatine for the gym, nothing in the current evidence points to a reason to stop. Sperm cells naturally run high concentrations of creatine as part of their normal energy metabolism.
• Second trimester. Since sperm takes roughly two to three months to fully develop, any effect of a supplement, good or bad, would show up on that timeline rather than overnight. Small human trials so far haven't found that creatine changes sperm count or quality either way, though the studies are still limited.
• Third trimester. If trying continues for a while without success, that's worth raising with a doctor for a fertility evaluation regardless of your supplement routine. Creatine itself is not something the evidence points to as a reason for a delay.