Effect of the oral intake of astaxanthin on semen parameters in patients with oligo-astheno-teratozoospermia: a randomized double-blind placebo-controlled trial
A prospective randomized double-blind placebo-controlled trial was carried out to comprehensively assess the effect of astaxanthin on infertile males diagnosed with oligospermia with/without asthenozoospermia or teratozoospermia (O±A±T).
Initially a total of 130 males, from November 2014 to January 2019, were recruited for assessment at the outpatient infertility clinic within the University Medical Centre Ljubljana, Slovenia.
Oligo-astheno-teratozoospermia (OAT) was assessed according to WHO 2010 guidelines while males diagnosed with genetic causes of infertility, endocrinopathies, genital tract infections, undescended testis, systemic diseases, history of testicular cancer, medication, food supplements or smoking (>20 cigarettes/day), were excluded from the study to minimise potential bias.
Following assessment, 50 males were excluded from the study and 80 eligible males enrolled. Each participant was randomly allocated to receive either 16mg of astaxanthin daily for 3 months or identical (in appearance and taste) placebo capsules produced by the same manufacturer. Randomization was carried out by a third party to ensure both participants and researchers were blinded to the allocations.
A questionnaire was also used, initially and at trial end, to capture any change in height, weight, smoking status, job type, exposure to high temperatures, ultraviolet or radiology radiation and chemicals, which could simultaneously influence the results.
Semen samples were collected after 2-5 days of abstinence and assessed according to WHO guidelines. DNA fragmentation was carried out (TUNEL assay) while mitochondrial membrane potential (MMP) and serum FSH levels were also measured.
At the end of the trial, 8 participants were lost to follow up, resulting in 37 men in the treatment group (Astaxanthin) and 35 in the placebo control group.
Baseline results showed that all patients in the treatment group were defined as OAT according to WHO criteria, while in the placebo control group only two thirds of all patients were defined as OAT and one third as oligo-teratozoospermia. No other statistically significant differences were found between the 2 groups.
Due to only a few mobile/immobile spermatozoa present motility results from 12 males in treatment group and 15 in the placebo was excluded from analysis.
Regardless analysis of semen results showed no statistically significant improvement (P > 0.1) in either semen parameters, DNA fragmentation, MMP or FSH levels in the treatment (Astaxanthin) group.
Interestingly total sperm number (16.0 to 38.4 million/ejaculate) and sperm concentration (5.7 to 10.2 million/ml) significantly improved in the placebo controlled group. A similar but non-significant increase for total sperm number (24.6 to 31.7 million/ejaculate) and sperm concentration (7.0 to 9.2 million/ml) among the treatment group was seen.
The authors speculated if seasonal changes in semen quality could account for this finding however re-analysis of participants results according to seasons did not show any difference (P = 0.995).
Finally the relatively high FSH level (mean 9.7 ±7.8 IU/I) ) indicates an imbalance in the pituitary-gonadal endocrine axis and hypogonadism, among this study population, known to cause germinal epithelial damage and severe OAT.
SUMMARY: ASTAXANTHIN EFFECT ON SPERM QUALITY
In this randomized double-blind placebo-controlled trial, 12mg a day of the antioxidant astaxanthin, for 3 months, did not improve total sperm number, concentration, motility, morphology, mitochondrial membrane potential or DNA fragmentation levels in males with oligo-astheno-teratozoospermia.
Limitations
- One third of patients had only a few mobile or immobile spermatozoa, significantly reducing study size of these parameters
Similar studies
Steiner A Z, et al. (2020). The effect of antioxidants on male factor infertility: the Males, Antioxidants, and Infertility (MOXI) randomized clinical trial. https://doi.org/10.1016/j.fertnstert.2019.11.008
Comhaire F H, et al. (2005). Combined conventional/antioxidant “Astaxanthin” treatment for male infertility: a double blind, randomized trial. https://doi.org/10.1111/j.1745-7262.2005.00047.x
fertilPEDIA
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