Role of antioxidants in male subfertility

 

Role of antioxidants oral to males where DNA fragmentation was documented : One trial reported DNA fragmentation. There was a difference (OR -13.80, (-17.50 to -10.10; P =  < 0.00001)) in favour of the antioxidant group over the placebo. What about effects of oral antioxidants on Total sperm motility: Antioxidant supplementation in men compared to placebo was associated with an improvement in total sperm motility. Conclusions:

 There is some evidence that antioxidant supplementation in subfertile

males may improve the outcomes of live birth, pregnancy rate and sperm

parameters for subfertile couples.

 

Ref:à Poster paper : P-006 Oral anti-oxidant use for male partners of couples undergoing

fertility treatments : Courtsey :Abstracts of the 26th Annual Meeting of ESHRE, Rome, Italy, 27 June – 30 June, 2010:M.G. Showell1, J. Brown1, A. Yazdani2, M.T. Stankiewicz3, R.J. Hart4

 

Introduction: Between 30%-80% of male subfertility cases are considered

to be due to the damaging effects of oxidative stress on sperm. Oral

supplementation with antioxidants may improve sperm quality by reducing

oxidative stress. This Cochrane review aimed to evaluate the effect of oral supplementation with antioxidants on male partners of couples attending a

fertility clinic.   , Materials and Methods: All RCTs of oral antioxidant supplements in men

were searched in the following sources: the Cochrane Menstrual Disorders and

Subfertility Group Register, MEDLINE, CENTRAL, EMBASE, CINAHL,

PSYCINFO and AMED databases (from their inception until January 2010),

trial registers, unpublished literature, reference lists and experts in the field.

RCTs comparing any type or dose of antioxidant (single or combined) versus

placebo, no treatment or another antioxidant that were taken by the male partner

of a couple seeking fertility assistance were included. The outcomes were live

birth, pregnancy, miscarriage, or spontaneous abortion, stillbirth, level of sperm

DNA damage, sperm motility, sperm concentration and adverse effects.We performed statistical meta-analyses in accordance with the guidelines

developed by The Cochrane Collaboration for the effect of antioxidant/s versus

placebo per couple randomised.Results: Fifty trials were considered and 32 met the inclusion criteria. 2696 couples in total. Reports of Cochrane :à Live birth; Two trials reported live birth. The use of antioxidants in men compared to placebo was associated with an increased live birth rate (pooled

odds ratio (OR) 6.44, (1.72 to 24.04, I2 = 0%, p < 0.006)). This result was based

on 10 live births from a total of 117 couples in the two studies. One of these

trials included couples undergoing IVF.Pregnancy rate; There were 79 pregnancies in 11 trials including 795 couples. Antioxidant use compared to placebo was associated with an increased

pregnancy rate (pooled OR 3.89 (2.33 to 6.49, I2 = 0, p < 0.00001)). Sensitivity

analysis on two trials that included couples undergoing IVF showed that the use

of antioxidant remains associated with increased pregnancy rate (pooled OR

4.22, (2.33 to 7.63, I2 = 0%, p < 0.00001).

What about miscarriage rate ?

Miscarriage rate: There was no evidence of an effect on miscarriage rates,

(pooled OR 1.15 (0.21 to 6.28; p = 0.87)) between the antioxidant and placebo

groups in two trials, 145 couples. What about Still Birth: There were no trials reporting stillbirth.

 

Role of antioxidants oral to males where DNA fragmentation was documented : One trial reported DNA fragmentation. There was a difference (OR -13.80, (-17.50 to -10.10; P =  < 0.00001)) in favour of the antioxidant group over the placebo. What about effects of oral antioxidants on Total sperm motility: Antioxidant supplementation in men compared to placebo was associated with an improvement in total sperm motility for the

following timeframes:

 

1. at =3 months: pooled OR 9.88 (7.17 to 12.59; I2 52%, p < 0.00001). 348

participants studied in seven trials. 2. at 6 months pooled OR 4.19 (3.81 to 4.56; I2 89%, p < 0.00001). 915

participants studied in seven trials. 3. at =9 months: pooled OR 1.38, (0.81 to 1.95; I2 64%, p < 0.00001). 332

participants in three trials.

 

Sperm concentration antioxidant use compared to placebo was associated

with an improvement in sperm concentration within the following time

frames:

 

1. at =3 months: There was no beneficial effect determined; pooled OR

2.64, (-0.52 to 5.81; p = 0.10), six trials of 290 participants.

 

2. at 6 months; pooled OR 5.25, (4.43 to 6.08; p < 0.00001; I2 53%), six

trials of 825 participants.

 

3. at =9 months; pooled OR 1.61 (0.61 to 2.61; P = 0.002, I2 0%), three

trials of 332 participants.

 

Side effects: No studies reported evidence of harmful side effects of the

antioxidant therapy used.