Literature review is devoted to the analysis of modern data on the use of docosahexaenoic acid in the treatment of male infertility. A brief description of modern ideas about the possible causes of male infertility (a disturbance of function of the cell membrane and genetic damage of sperm) was conducted. The data on the anti-inflammatory properties of omega-3 polyunsaturated fatty acids are described in detail. The bioavailability of docosahexaenoic acid and the choice of drugs containing it for the treatment of male infertility are discussed. Increasing the content of polyunsaturated fatty acids, in particular docosahexaenoic acid, in the sperm membrane was associated with higher ejaculate quality. Therapy with the use of these substances led to the improvement of standard indicators of semen and a decrease in the proportion of sperm with fragmented DNA.

No abstract

No abstract

Introduction. Antioxidant supplementation therapy continues to be the main treatment for male infertility associated with high level of sperm DNA damage. Docosahexaenoic acid (DHA) is one of the most promising components of antioxidant supplementation therapy. It also has anti-inflammatory properties that makes it interesting for treatment of patients with high level of sperm DNA damage and inflammation in male accessory glands.Materials and methods.One hundred and seventeen (117) infertile patients with high level of sperm DNA damage were recruited for this randomized, double blind, placebo-controlled study. Semen analysis, MAR-test, SCD test and sperm cryotolerance test were performed to all patients. Subjects were divided into 2 groups with high (>1 mln / ml) and low (<1 mln / ml) semen leucocyte concertation and then randomized into 2 subgroups of active treatment and 2 placebo subgroups. The active treatment subgroups received 1470 mg / day of DHA for 3 months. The placebo group received placebo for the same period. Laboratory tests were repeated after the treatment course had been finished.Results. Statistically significant increase in motility (42 % (25–61 %) vs 25 % (15–47 %), p <0.05), vitality (73 % (63–81 %) vs 41 % (35–64 %), p <0.05), decrease in sperm DNA fragmentation level (21 % (12–28 %) vs 33 % (25–39 %), p <0.05) and leucocyte concentration (1 million / ml (0.7–1.7 million / ml) vs 1,5 million / ml (1.1–2.1 million / ml), p <0.05) were observed in the subgroup with male accessory glands inflammation after treatment. Motility (15 % (8–19 %) vs 8 % (5–11 %), p <0.05) and vitality (37 % (25–46 %) vs 24 % (17–40 %), p <0.05) in this subgroup after a sperm cryotolerance test increased as well. In the subgroup with low semen leucocyte concertation statistically significant increase in motility (43 % (27–63 %) vs 34 % (21–54 %), p <0.05), vitality (77 % (66–85 %) vs 65 % (54.5–76.0 %), p <0.05) and decrease of sperm DNA fragmentation level (9 % (5.5–20.0 %) vs 25 % (18–33 %), p <0.05) were observed. DHA supplementation also resulted in statistically significant increase in motility (17 % (10–23 %) vs 6 % (5.0–10.5 %), p <0.05) and vitality (41 % (32.5–53.0 %) vs 37 % (30–49 %), p <0.05) after a sperm cryotolerance test in that subgroup.Conclusion. DHA supplementation therapy increases motility, vitality, sperm cryotolerance and decreases sperm DNA fragmentation regardless of the presence of an inflammatory process in male accessory glands.

Male accessory glands infections (MAGI) are considered one of the causes of male infertility. Chronic prostatitis is the most prevalent form of MAGI. Researches that assessed the influence of chronic prostatitis on conventional semen parameters have shown contradictory results, so the debate regarding this issue continues. Conventional semen parameters are imperfect markers of male fertility, as many men remain infertile despite being normozoospermic. The search for reliable predictors of male fertility continues to this day. Oxidative stress is considered one of the main pathogenetic mechanisms of male infertility. Free radical oxidation is the leading cause of spermatozoa DNA damage. Spermatozoa DNA fragmentation caused by oxidative stress was associated with a number of unsuccessful reproductive outcomes. There are several factors that are responsible for making spermatozoa vulnerable to free radical damage including abnormal maturation characterized by insufficient chromatin protamination. Acrosin activity defines the ability of spermatozoa to penetrate the ovum membrane and is therefore an independent marker of spermatozoa fertilizing capacity. Possible mechanisms of chronic prostatitis influence on male fertility and current scientific data regarding its association with novel predictors of male infertility are discussed in this article.The study did not have sponsorship. The authors have declared no conflicts of interest.