The Effect of Antioxidants on Sperm Quality Parameters and Pregnancy Rates for Idiopathic Male Infertility: A Network Meta-Analysis of Randomized Controlled Trials

Abstract

PurposeMale infertility is a global public health issue recognized by the WHO. Recently, antioxidants are increasingly used to treat idiopathic male infertility. However, the lack of available evidence has led to the inability to rank the effects of antioxidants on the sperm quality parameters and pregnancy rate of infertile men. This network meta-analysis studied the effects of different antioxidants on the sperm quality and pregnancy rate of idiopathic male infertility.MethodsWe searched PubMed, Embase, Web of Science, and Cochrane Library databases for randomized controlled trials (RCTs). The weighted mean difference (WMD) and odds ratio (OR) were applied for the comparison of continuous and dichotomous variables, respectively, with 95% CIs. The outcomes were sperm motility, sperm concentration, sperm morphology, and pregnancy rate.ResultsA total of 23 RCTs with 1,917 patients and 10 kids of antioxidants were included. l-Carnitine, l-carnitine+l-acetylcarnitine, coenzyme-Q10, ω-3 fatty acid, and selenium were more efficacious than placebo in sperm quality parameters. l-Carnitine was ranked first in sperm motility and sperm morphology (WMD 6.52% [95% CI: 2.55% to 10.05%], WMD 4.96% [0.20% to 9.73%]). ω-3 fatty acid was ranked first in sperm concentration (WMD 9.89 × 106/ml, [95% CI: 7.01 to 12.77 × 106/ml]). In terms of pregnancy rate, there was no significant effect as compared with placebo.Conclusionsl-Carnitine was ranked first in sperm motility and sperm morphology. ω-3 fatty acid was ranked first in sperm concentration. Coenzyme-Q10 had better effective treatment on sperm motility and concentration. Furthermore, high-quality RCTs with adequate sample sizes should be conducted to compare the outcomes of different antioxidants.

Novel Potency Assay for MSC Secretome-Based Treatment of Idiopathic Male Infertility Employed Leydig Cells and Revealed Vascular Endothelial Growth Factor as a Promising Potency Marker

“…Among cases of male infertility, idiopathic male infertility predominates [ 24 ]. Empirical therapy with antioxidants, SERMs, or hormones might improve some sperm parameters but does not show a significant effectiveness in pregnancy rates, which serve as the most objective outcome to show the effect of treatment for male infertility [ 3 , 4 , 24 , 25 ]. This may be because the pathogenesis of male infertility cannot be fully modified by the aforementioned drugs.…”

Bibliometric and visual analysis on oxidative stress in gynecological and reproductive diseases: A systematic review

“…[36][37][38][39] Different antioxidants serve specific functions, for example, CoQ10 and l-carnitine aid sperm motility and concentration, while vitamin C improves sperm morphology. [40,41] In vitro studies suggest that OS is a primary factor affecting the survival and fertilization capacity of cryopreserved sperm. During assisted reproductive technology procedures, factors such as exposure to visible light, centrifugation, cryopreservation, medium composition, O2 tension, PH value, and temperature can induce OS, adversely affecting sperm quality.…”

Male preconceptional training: the role of nutrition and nutrient complexes. Part 1.

“…в рандомизированном плацебо-контролируемом исследовании не было выявлено улучшения параметров спермы у мужчин, получавших карнитины [15]. Недавний парный и сетевой мета-анализ рандомизированных исследований (сравнение препаратов с плацебо и с другими субстанциями) показал, что карнитин способен значимо увеличить прогрессивную подвижность, и даже улучшить морфологию сперматозоидов при астено-и тератозооспермии: подвижность увеличилась на 8,7%, концентрация -на 3,5 млн/мл, процент нормальных формна 3,1% [16].…”

“…Однако в исследованиях не учитывался исходный уровень селена у бесплодных мужчин, поступление селена с продуктами питания и влияние приема биологически активных добавок селена на мужчин с низким и хорошим уровнем селена в крови. По данным уже цитируемого недавнего сетевого мета-анализа селен повышает подвижность в среднем на 3,3%, концентрацию -на 3,9 млн/мл, морфология сперматозоидов при этом не изменяется [16].…”