The combined effect of lifestyle intervention and antioxidant therapy on sperm DNA fragmentation and seminal oxidative stress in IVF patients: a pilot study

Abstract

Purpose: Sperm DNA fragmentation (SDF) and seminal oxidative stress are emerging measurable factors in male factor infertility, which interventions could potentially reduce. We evaluated (i) the impact of lifestyle changes combined with oral antioxidant intake on sperm DNA fragmentation index (DFI) and static oxidation-reduction potential (sORP), and (ii) the correlation between DFI and sORP. Materials and Methods: We conducted a prospective study involving 93 infertile males with a history of failed IVF/ICSI. Ten healthy male volunteers served as controls. Semen analysis was carried out according to 2010 WHO manual, whereas seminal sORP was measured using the MiOXSYS platform. SDF was assessed by sperm chromatin structure assay. Participants with DFI >15% underwent a three-month lifestyle intervention program, primarily based on diet and exercise, combined with oral antioxidant therapy using multivitamins, coenzyme Q10, omega-3, and oligo-elements. We assessed changes in semen parameters, DFI, and sORP, and compared DFI results to those of volunteers obtained two weeks apart. Spearman rank correlation tests were computed for sORP and DFI results. Results: Thirty-eight (40.8%) patients had DFI >15%, of whom 31 participated in the intervention program. A signifi cant decrease in median DFI from 25.8% to 18.0% was seen after the intervention (P <0.0001). The mean DFI decrease was 7.2% (95% CI: 4.8-9.5%; P <0.0001), whereas it was 0.42% (95%CI; -4.8 to 5.6%) in volunteers (P <0.00001). No differences were observed in sperm parameters and sORP. Based on paired sORP and DFI data from 86 patients, no correlation was observed between sORP and DFI values (rho=0.03). Conclusion: A 3-month lifestyle intervention program combined with antioxidant therapy reduced DFI in infertile men with elevated SDF and a history of failed IVF/ICSI. A personalized lifestyle and antioxidant intervention could improve fertility of subfertile couples through a reduction in DFI, albeit controlled trials evaluating reproductive outcomes are needed before fi rm conclusions can be made. Trial registration number and date: clinicaltrials.gov NCT03898752, April 2, 2019.

Coenzyme Q10 improves sperm motility and antioxidant status in infertile men with idiopathic oligoasthenospermia

“…Additionally, recent reports have suggested anti-apoptotic, anti-inflammatory, and gene modulation effects for CoQ10, which could explain the use of CoQ10 for the treatment of other diseases such as ischemic heart diseases, Parkinson's disease, diabetes mellitus, and malignant tumors in addition to infertility [36,38,39]. We [12,35,40] and others [41][42][43] have also detected higher SDF in men with IMI, and these levels were ameliorated by CoQ10 therapy. These findings augment the role of CoQ10 as a gene modulator.…”

Analysis of research trends (2014-2023) on oxidative stress and male fertility based on bibliometrics and knowledge graphs

“…Antioxidant therapy is considered one of the crucial strategies for improving sperm quality ( 73 ). Maintaining a healthy diet and lifestyle is the primary approach to reducing oxidative stress within the body ( 74 ). Additionally, treatments such as surgery for varicocele ( 75 ) and anti-inflammatory therapies ( 76 ) have been shown through research to effectively enhance semen ROS (Reactive Oxygen Species) levels.…”

Sperm DNA fragmentation testing in clinical management of reproductive medicine

“…revealed that impaired glycemic control and smoking are associated with higher levels of SDF 13 . This suggests that adopting a healthy lifestyle, which includes a balanced diet, regular exercise, and refraining from smoking, may help reduce or prevent high levels of SDF 96 . Specifically, engaging in high‐intensity exercises, following a diet rich in vegetables, fish, seafood, and whole grains (e.g., the Mediterranean diet), and reducing alcohol intake may have favorable effects on SDF 97 .…”