Antioxidant treatment of increased sperm DNA fragmentation: Complex combinations are not more successful


Submitted: August 3, 2020
Accepted: September 8, 2020
Published: December 21, 2020
Abstract Views: 809
PDF: 434
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Authors

Objective: Oral antioxidant supplementation is part of the treatment of infertility associated with oxidative stress-related sperm damage. It is possible to assume that the combined use of antioxidants will be better than single agent use. The purpose of this study was to compare the effectiveness of different antioxidant combinations in infertile men with increased sperm DNA fragmentation. Materials and methods: We retrospectively reviewed the records of 637 patients who underwent antioxidant support therapy for increased sperm DNA damage between 2014 and 2019. Patients with DNA damage of 30% or more were included study. Result: A total of 163 patients with follow-up data and who fulfilled the study criteria were included in the study. There were four different treatment groups. No statistically significant differences were found between the groups. After 3 months of antioxidant treatment, there was a statistically significant decrease in sperm DNA damage in all treatment groups. However, there was no statistically significant difference between the treatment groups. Conclusions: The complexity of the antioxidant combination may not contribute to the success of the treatment or may cause possible side effects, increase the cost of treatment and decrease patient compliance.


Komiya A, Kato T, Kawauchi Y, Watanabe A, Fuse H. Clinical factors associated with sperm DNA fragmentation in male patients with infertility. Scientific World Journal 2014;2014:868303. DOI: https://doi.org/10.1155/2014/868303

Santi D, Spaggiari G, Simoni M. Sperm DNA fragmentation index as a promising predictive tool for male infertility diagnosis and treatment management - meta-analyses. Reprod Biomed Online 2018;37:315-326. DOI: https://doi.org/10.1016/j.rbmo.2018.06.023

Bungum M. Sperm DNA integrity assessment: a new tool in diagnosis and treatment of fertility. Obstet Gynecol Int 2012;2012:531042. DOI: https://doi.org/10.1155/2012/531042

Agarwal A, Said TM. Role of sperm chromatin abnormalities and DNA damage in male infertility. Hum Reprod Update 2003;9:331-345. DOI: https://doi.org/10.1093/humupd/dmg027

Sakkas D, Mariethoz E, Manicardi G, Bizzaro D, Bianchi PG, Bianchi U. Origin of DNA damage in ejaculated human spermatozoa. Rev Reprod 1999;4:31-37. DOI: https://doi.org/10.1530/ror.0.0040031

Agarwal A, Cho CL, Esteves SC. Should we evaluate and treat sperm DNA fragmentation? Curr Opin Obstet Gynecol 2016;28:164-171. DOI: https://doi.org/10.1097/GCO.0000000000000271

Evgeni E, Charalabopoulos K, Asimakopoulos B. Human sperm DNA fragmentation and its correlation with conventional semen parameters. J Reprod Infertil 2014;15:2-14.

Wright C, Milne S, Leeson H. Sperm DNA damage caused by oxidative stress: modifiable clinical, lifestyle and nutritional factors in male infertility. Reprod Biomed Online 2014;28:684-703. DOI: https://doi.org/10.1016/j.rbmo.2014.02.004

Lewis SE, John Aitken R, Conner SJ, et al. The impact of sperm DNA damage in assisted conception and beyond: recent advances in diagnosis and treatment. Reprod Biomed Online 2013;27:325-337. DOI: https://doi.org/10.1016/j.rbmo.2013.06.014

Pourmasumi S, Sabeti P, Rahiminia T, Mangoli E, Tabibnejad N, Talebi AR. The etiologies of DNA abnormalities in male infertility: An assessment and review. Int J Reprod Biomed (Yazd) 2017;15:331-344. DOI: https://doi.org/10.29252/ijrm.15.6.331

Moustafa MH, Sharma RK, Thornton J, et al. Relationship between ROS production, apoptosis and DNA denaturation in spermatozoa from patients examined for infertility. Hum Reprod 2004;19:129-138. DOI: https://doi.org/10.1093/humrep/deh024

Pham-Huy LA, He H, Pham-Huy C. Free radicals, antioxidants in disease and health. Int J Biomed Sci 2008;4:89-96.

Kao SH, Chao HT, Chen HW, Hwang TI, Liao TL, Wei YH. Increase of oxidative stress in human sperm with lower motility. Fertil Steril 2008;89:1183-1190. DOI: https://doi.org/10.1016/j.fertnstert.2007.05.029

Calogero AE, Condorelli RA, Russo GI, La Vignera S. Conservative Nonhormonal Options for the Treatment of Male Infertility: Antibiotics, Anti-Inflammatory Drugs, and Antioxidants. Biomed Res Int 2017;2017:4650182. DOI: https://doi.org/10.1155/2017/4650182

Walczak-Jedrzejowska R, Wolski JK, Slowikowska-Hilczer J. The role of oxidative stress and antioxidants in male fertility. Cent European J Urol 2013;66:60-67. DOI: https://doi.org/10.5173/ceju.2013.01.art19

Zini A, Al-Hathal N. Antioxidant therapy in male infertility: fact or fiction? Asian J Androl 2011;13:374-381. DOI: https://doi.org/10.1038/aja.2010.182

Alahmar AT. Role of Oxidative Stress in Male Infertility: An Updated Review. J Hum Reprod Sci 2019;12:4-18. DOI: https://doi.org/10.4103/jhrs.JHRS_150_18

Gharagozloo P, Aitken RJ. The role of sperm oxidative stress in male infertility and the significance of oral antioxidant therapy. Hum Reprod 2011;26:1628-1640. DOI: https://doi.org/10.1093/humrep/der132

Alahmar AT. The impact of two doses of coenzyme Q10 on semen parameters and antioxidant status in men with idiopathic oligoasthenoteratozoospermia. Clin Exp Reprod Med 2019;46:112-118. DOI: https://doi.org/10.5653/cerm.2019.00136

Agarwal A, Nallella KP, Allamaneni SS, Said TM. Role of antioxidants in treatment of male infertility: an overview of the literature. Reprod Biomed Online 2004;8:616-627. DOI: https://doi.org/10.1016/S1472-6483(10)61641-0

McDonald HP, Garg AX, Haynes RB. Interventions to enhance patient adherence to medication prescriptions: scientific review. JAMA 2002;288:2868-2879. DOI: https://doi.org/10.1001/jama.288.22.2868

Ozer, C. (2020). Antioxidant treatment of increased sperm DNA fragmentation: Complex combinations are not more successful. Archivio Italiano Di Urologia E Andrologia, 92(4). https://doi.org/10.4081/aiua.2020.4.362

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