Antioxidants for male subfertility

Smits, Roos M.; Mackenzie‐Proctor, Rebecca; Yazdani, Anusch; Stankiewicz, M.; Jordan, Vanessa; Showell, Marian

doi:10.1002/14651858.cd007411.pub4

Cited by 204 publications

(282 citation statements)

References 203 publications

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“…As a naturally rich source of vitamins, minerals, and polyphenols, the DASH diet may be perceived as antioxidative and anti-inflammatory. The antioxidants in male reproductive health may be positively associated with semen parameters [31][32][33], fertilization rate [34], decreasing oxidative damage to spermatozoa [35,36], DNA maintenance, transfer RNA, protein synthesis [37], and the reduction of the negative effects of inflammation [36,38]. Moreover, the DASH diet recommends a reduction in sweets, meat, eggs, and fat consumption that, due to the content of sugars, saturated/trans fatty acids, and sodium, may adversely affect sperm count [28], concentration [39,40], sperm motility [29,40,41], and morphology [40,41].…”

Section: Discussionmentioning

confidence: 99%

Association of the Dietary Approaches to Stop Hypertension, Physical Activity, and Their Combination with Semen Quality: A Cross-Sectional Study

et al. 2019

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The influence of individual lifestyle factors is widely described in studies on semen quality. However, their synergistic effect is often neglected. The aim of the study was to examine the association between semen quality and dietary approaches to stop hypertension (DASH) diet, physical activity (PA), and the two separately and in combination. A cross-sectional study was carried out among 207 men aged 20-55. Dietary data were collected by a food frequency questionnaire (FFQ) and analysed according to the DASH scoring index. Physical activity was evaluated by the International Physical Activity Questionnaire. Semen parameters were assessed via the computer-aided semen analysis (CASA). Adherence to the DASH diet was associated with higher sperm count (∆ T3-T1 = 82.1 mln/ej) and concentration (∆ T3-T1 = 24.6 mln/mL). Higher PA was related to higher sperm count (∆ T3-T1 = 69.4 mln/ej), total (∆ T3-T1 = 11.9%), and progressive motility (∆ T3-T1 = 8.5%) and morphology (∆ T3-T1 = 2.8%) in the crude model and remained significant after adjustment. The combination of the DASH diet and PA, was significantly positively associated with sperm count (∆ T3-T1 = 98.1 mln/ej), sperm concentration (∆ T3-T1 = 17.5 mln/mL), total (∆ T3-T1 = 11.8%), and progressive motility (∆ T3-T1 = 10.0%) and morphology (∆ T3-T1 = 3.3%) in both models. Adherence to the DASH diet was related to higher sperm count and concentration, whereas after its combination with physical activity it was also positively correlated with sperm motility and morphology.Most of the epidemiological studies have assessed the effects of single foods, nutrients and other lifestyle factors on semen parameters [6-9], whereas their synergistic effect is neglected. Some lifestyle behaviours co-occur together and in combination are more beneficial to health than their cumulative individual effect. Moreover, interventions aimed at multiple-behaviour change may have a potentially greater impact on health than interventions based on a single risk factor [10].The easiest modifiable lifestyle factors, with the important impact on semen quality, are diet and physical activity. The dietary approaches to stop hypertension (DASH) diet is one of the most well-known dietary strategies, and its effect is often linked with prevention and treatment of hypertension, diabetes, obesity, and coronary artery disease [11]. Moreover, its effects were studied in the context of other diseases [12], including semen quality [13]. The DASH diet can be adapted to any variance in regional diet, which can make lifestyle-related health factors grow more sustainable [14]. The DASH diet reflects a healthy eating pattern holistically, promoting food such as food sources of vitamins, minerals, and antioxidants, and limiting food high in saturated fats, sugar, and sodium. Previous research has indicated that this dietary pattern may be important to maintain proper semen quality [6,13].Physical activity is one of the health promoting lifestyle factors. However, earlier studies describing a link between physica...

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Section: Discussionmentioning

confidence: 99%

Association of the Dietary Approaches to Stop Hypertension, Physical Activity, and Their Combination with Semen Quality: A Cross-Sectional Study

et al. 2019

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“…representing between 1.7-and 3.7-fold increase [107]. While these results seem to be promising, the authors of that study warned about the increase in miscarriage rates (from 2% to 13%) following antioxidant supplementation.…”

Section: Use Of Antioxidants For Natural Pregnancymentioning

confidence: 92%

“…Since not only does an increase in oxidative stress reduce sperm quality but also the likelihood of achieving pregnancy (either natural or through ART), the use of exogenous antioxidants has been proposed to balance the ROS:antioxidant ratio and increase the sperm quality. In the literature, several non-enzymatic antioxidants, such as arginine, carnitine, carotenoids, coenzyme Q10, cysteine, reduced glutathione, micronutrients like selenium or zinc, vitamin E, vitamin C, myo-inositol, or resveratrol, have been reported to be utilized to treat different diseases [107]. In the case of ART, exogenous antioxidants have been tested for decades, and several works point out to a positive contribution of these supplements on sperm count, motility, and morphology [108][109][110].…”

Section: Antioxidantsmentioning

confidence: 99%

“…The latest review of the Cochrane Library including high quality studies concludes that the antioxidant intake by male patients is associated to an increase in live birth rates from 12% to 14-26%, representing between 1.2-and 2.1-fold increase. The same meta-analysis included eleven studies analyzing natural pregnancy and showed that antioxidant supplementation increases pregnancy rates from 7% to 12-26%, representing between 1.7-and 3.7-fold increase [107]. While these results seem to be promising, the authors of that study warned about the increase in miscarriage rates (from 2% to 13%) following antioxidant supplementation.…”

Section: Use Of Antioxidants For Natural Pregnancymentioning

confidence: 99%

“…While these results seem to be promising, the authors of that study warned about the increase in miscarriage rates (from 2% to 13%) following antioxidant supplementation. This detrimental effect, however, was concluded from few studies (only three) meeting the quality criteria (randomized, prospective, and double-blinded) [107]. Antioxidant treatments for male fertility have been used for decades.…”

Section: Use Of Antioxidants For Natural Pregnancymentioning

confidence: 99%

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Oxidative Stress in Male Infertility: Causes, Effects in Assisted Reproductive Techniques, and Protective Support of Antioxidants

Ribas-Maynou

Yeste

2020

Biology

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The spermatozoon is a highly specialized cell, whose main function is the transport of the intact male genetic material into the oocyte. During its formation and transit throughout male and female reproductive tracts, sperm cells are internally and externally surrounded by reactive oxygen species (ROS), which are produced from both endogenous and exogenous sources. While low amounts of ROS are known to be necessary for crucial physiological sperm processes, such as acrosome reaction and sperm–oocyte interaction, high levels of those species underlie misbalanced antioxidant-oxidant molecules, generating oxidative stress (OS), which is one of the most damaging factors that affect sperm function and lower male fertility potential. The present work starts by reviewing the different sources of oxidative stress that affect sperm cells, continues by summarizing the detrimental effects of OS on the male germline, and discusses previous studies addressing the consequences of these detrimental effects on natural pregnancy and assisted reproductive techniques effectiveness. The last section is focused on how antioxidants can counteract the effects of ROS and how sperm fertilizing ability may benefit from these agents.

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Effect of Folic Acid and Zinc Supplementation in Men on Semen Quality and Live Birth Among Couples Undergoing Infertility Treatment

Schisterman

Sjaarda

Clemons

et al. 2020

JAMA

134

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IMPORTANCE Dietary supplements marketed for male fertility commonly contain folic acid and zinc based on limited prior evidence for improving semen quality. However, no large-scale trial has examined the efficacy of this therapy for improving semen quality or live birth.OBJECTIVE To determine the effect of daily folic acid and zinc supplementation on semen quality and live birth. DESIGN, SETTING, AND PARTICIPANTSThe Folic Acid and Zinc Supplementation Trial was a multicenter randomized clinical trial. Couples (n = 2370; men aged Ն18 years and women aged 18-45 years) planning infertility treatment were enrolled at 4 US reproductive endocrinology and infertility care study centers between June 2013 and December 2017. The last 6-month study visit for semen collection occurred during August 2018, with chart abstraction of live birth and pregnancy information completed during April 2019.INTERVENTIONS Men were block randomized by study center and planned infertility treatment (in vitro fertilization, other treatment at a study site, and other treatment at an outside clinic) to receive either 5 mg of folic acid and 30 mg of elemental zinc (n = 1185) or placebo (n = 1185) daily for 6 months. MAIN OUTCOMES AND MEASURESThe co-primary outcomes were live birth (resulting from pregnancies occurring within 9 months of randomization) and semen quality parameters (sperm concentration, motility, morphology, volume, DNA fragmentation, and total motile sperm count) at 6 months after randomization. RESULTS Among 2370 men who were randomized (mean age, 33 years), 1773 (75%) attended the final 6-month study visit. Live birth outcomes were available for all couples, and 1629 men (69%) had semen available for analysis at 6 months after randomization. Live birth was not significantly different between treatment groups (404 [34%] in the folic acid and zinc group and 416 [35%] in the placebo group; risk difference, −0.9% [95% CI, −4.7% to 2.8%]). Most of the semen quality parameters (sperm concentration, motility, morphology, volume, and total motile sperm count) were not significantly different between treatment groups at 6 months after randomization. A statistically significant increase in DNA fragmentation was observed with folic acid and zinc supplementation (mean of 29.7% for percentage of DNA fragmentation in the folic acid and zinc group and 27.2% in the placebo group; mean difference, 2.4% [95% CI, 0.5% to 4.4%]). Gastrointestinal symptoms were more common with folic acid and zinc supplementation compared with placebo (abdominal discomfort or pain: 66 [6%] vs 40 [3%], respectively; nausea: 50 [4%] vs 24 [2%]; and vomiting: 32 [3%] vs 17 [1%]).CONCLUSIONS AND RELEVANCE Among a general population of couples seeking infertility treatment, the use of folic acid and zinc supplementation by male partners, compared with placebo, did not significantly improve semen quality or couples' live birth rates. These findings do not support the use of folic acid and zinc supplementation by male partners in the treatment of infertility.

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Antioxidants for male subfertility

Abstract: Analysis 2.4. Comparison 2 Head-to-head antioxidant(s), Outcome 4 Total sperm motility at 6 months; type of antioxidant........ Analysis 2.5. Comparison 2 Head-to-head antioxidant(s), Outcome 5 Total sperm motility at 6 months

Cited by 204 publications

References 203 publications

Association of the Dietary Approaches to Stop Hypertension, Physical Activity, and Their Combination with Semen Quality: A Cross-Sectional Study

Association of the Dietary Approaches to Stop Hypertension, Physical Activity, and Their Combination with Semen Quality: A Cross-Sectional Study

Oxidative Stress in Male Infertility: Causes, Effects in Assisted Reproductive Techniques, and Protective Support of Antioxidants

Effect of Folic Acid and Zinc Supplementation in Men on Semen Quality and Live Birth Among Couples Undergoing Infertility Treatment

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