Antioxidant pretreatment for male partner before ART for male factor subfertility: a randomized controlled trial
An open-label randomized control study involving subfertile males was carried out to evaluate the effectiveness of antioxidants on potential live birth rates following ICSI. Subfertile males were defined as; mild oligozoospermia (sperm concentration: 5 million/ml to 15 million/ml), asthenozoospermia (sperm motility: 25% to 32%), and/or teratozoospermia (sperm morphology: <4%).
In total 135 couples (64 in the treatment group, 71 controls) participated and completed the trial. The males in the antioxidant treatment group, took Vitamin C (500mg), Vitamin E (400mg) and Zinc (140mg) daily for 3 months prior to ICSI. Semen analysis was carried out at the start and end of 3 months, for both groups of males.
Initial analysis showed a trend towards higher clinical pregnancy rates in the treatment group, however this did not significantly alter the ongoing pregnancy (33.3% vs 29.1%) or live birth rate (33.3% vs 27.8%), in the treatment vs control groups respectively. Further analysis confirmed that clinical pregnancy rate per embryo transfer was significantly higher (54.7% vs 36.6%), while fertilization rate, ongoing pregnancy and live births per embryo transfer was not significantly different between the groups.
Similarly sperm analysis showed no significant change in sperm concentration, progressive motility or morphology before and after 3 months treatment. Interestingly post hoc analysis within the treatment group, comparing males with improved sperm results to those with no improvement, found no difference in the rates of clinical pregnancy, ongoing pregnancy and live births.
SUMMARY: IS ANTIOXIDANTS GOOD FOR SPERM
This randomized control trial of antioxidant supplementation in subfertile males found that antioxidants was not helpful to sperm concentration, progressive motility or morphology after 3 months of treatment. Any potential benefit to sperm quality did not translate into increased live birth rates per embryo transfer.
- Low sample size
- DNA fragmentation not assessed limiting interpretation of results
- Open label trial
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
Exposito A, et al. (2016). A prospective double-blind randomized placebo-controlled study of the effect of vitamin E on semen parameters in infertile men. https://scholar.google.com/scholar_lookup?
Tremellen K, et al. (2007). A randomised control trial examining the effect of an antioxidant (Menevit) on pregnancy outcome during IVF-ICSI treatment. https://doi.org/10.1111/j.1479-828x.2007.00723.x
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