Systematic review of antioxidant types and doses in male infertility: Benefits on semen parameters, advanced sperm function, assisted reproduction and live-birth rate

• Published in: Arab Journal of Urology Vol. 16; no. 1; pp. 113 - 124
• Main Authors: Majzoub, Ahmad, Agarwal, Ashok
• Format: Journal Article
• Language: English
• Published: United States Elsevier B.V 01.03.2018; Taylor & Francis; Elsevier
• Subjects: Antioxidants; assisted reproductive therapy; co-enzyme Q10; coQ10; DDS; DNA degraded sperm; ICSI; in vitro fertilisation; intracytoplasmic sperm injection; IVF; l-acetyl carnitine; l-carnitine; LAC; Male infertility; Management; Medical Subject Heading; MeSH; N-acetyl cysteine; NAC; OAT; oligoasthenozoospermia; oxidative stress; Preferred Reporting Items for Systematic Reviews and Meta-Analyses; PRISMA; Reactive oxygen species; ROS; SDF; Semen analysis; Sperm DNA fragmentation; coQ10; Reactive oxygen species; ART; OAT; OS; MeSH; PRISMA; Sperm DNA fragmentation; LAC; Antioxidants; NAC; DDS; ICSI; SDF; Male infertility; LC; ROS; IVF; Semen analysis; LC, l-carnitine; NAC, N-acetyl cysteine; OS, oxidative stress; IVF, in vitro fertilisation; ART, assisted reproductive therapy; PRISMA, Preferred Reporting Items for Systematic Reviews and Meta-Analyses; ICSI, intracytoplasmic sperm injection; coQ10, co-enzyme Q10; OAT, oligoasthenozoospermia; SDF, sperm DNA fragmentation; MeSH, Medical Subject Heading; ROS, reactive oxygen species; DDS, DNA degraded sperm; LAC, l-acetyl carnitine
• ISSN: 2090-598X; 2090-5998; 2090-598X; 2090-5998
• DOI: 10.1016/j.aju.2017.11.013

To explore the current evidence concerning the effect of oral antioxidant supplementation on various male fertility outcomes, as antioxidants are widely available compounds that are commonly used for the treatment of male infertility. PubMed, Medline and Cochrane electronic databases were searched according to a modified Preferred Reporting Items for Systemic Reviews and Meta-Analyses (PRISMA) guidelines looking for studies investigating the effect of antioxidant therapy on infertile men. The studies were explored looking for antioxidants: (i) types and doses; (ii) mechanism of action and rationale for use; and (iii) effect on the different outcome measures reported. In all, 26 studies reported a significant positive effect of antioxidant therapy on basic semen parameters, advanced sperm function, outcomes of assisted reproductive therapy, and live-birth rate. Vitamin E, vitamin C, carnitines, N-acetyl cysteine, co-enzyme Q10, zinc, selenium, folic acid and lycopene were most commonly used. The vitamins’ mechanism of action and reported doses is presented in Tables 1 and 2. Antioxidants generally have a favourable effect on male fertility. Further studies are needed to identify the optimal antioxidant regimen that can be used safely and efficiently in clinical practice.