Impact of Antioxidant Therapy on Natural Pregnancy Outcomes and Semen Parameters in Infertile Men: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

被引：24

作者：

Agarwal, Ashok ^{[1
]}

Cannarella, Rossella ^{[2
,3
]}

Saleh, Ramadan ^{[4
,5
]}

Harraz, Ahmed M. ^{[6
,7
,8
]}

Kandil, Hussein ^{[9
]}

Salvio, Gianmaria ^{[10
]}

Boitrelle, Florence ^{[11
,12
]}

Kuroda, Shinnosuke ^{[3
]}

Farkouh, Ala'a ^{[1
]}

Rambhatla, Amarnath ^{[13
]}

Zini, Armand ^{[14
]}

Colpi, Giovanni ^{[15
]}

Gul, Murat ^{[16
]}

Kavoussi, Parviz ^{[17
]}

Hamoda, Taha Abo-Almagd Abdel-Meguid ^{[18
,19
]}

Ko, Edmund ^{[20
]}

Calik, Gokhan ^{[21
]}

Toprak, Tuncay ^{[22
]}

Pinggera, Germar-Michael ^{[23
]}

Park, Hyun Jun ^{[24
,25
]}

Abou Ghayda, Ramy ^{[26
]}

Minhas, Suks ^{[27
]}

Busetto, Gian Maria ^{[28
]}

Bakircioglu, Mustafa Emre ^{[29
]}

Kadioglu, Ates ^{[30
]}

Chung, Eric ^{[31
]}

Russo, Giorgio Ivan ^{[32
]}

Calogero, Aldo E. ^{[2
]}

Ambar, Rafael F. ^{[33
,34
]}

Jayasena, Channa N. ^{[35
,36
,37
]}

Shah, Rupin ^{[38
]}

机构：

[1] Amer Ctr Reprod Med, Global Androl Forum, 130 West Juniper Lane, Moreland Hills, OH 44022 USA

[2] Univ Catania, Dept Clin & Expt Med, Catania, Italy

[3] Cleveland Clin Fdn, Glickman Urol & Kidney Inst, 9500 Euclid Ave, Cleveland, OH 44195 USA

[4] Sohag Univ, Fac Med, Dept Dermatol Venereol & Androl, Sohag, Egypt

[5] Ajyal Hosp, Ajyal IVF Ctr, Sohag, Egypt

[6] Mansoura Univ, Dept Urol, Urol & Nephrol Ctr, Mansoura, Egypt

[7] Farwaniya Hosp, Dept Surg, Urol Unit, Farwaniya, Kuwait

[8] Sabah Al Ahmad Urol Ctr, Dept Urol, Kuwait, Kuwait

[9] Fakih IVF Fertil Ctr, Abu Dhabi, U Arab Emirates

[10] Polytech Univ Marche, Dept Endocrinol, Ancona, Italy

[11] Poissy Hosp, Reprod Biol Fertil Preservat Androl, CECOS, Poissy, France

[12] Pari Saclay Univ, Dept Biol Reprod Epigenet Environm & Dev, UVSQ, INRAE,BREED, Jouy En Josas, France

[13] Henry Ford Hlth Syst, Dept Urol, Vattikuti Urol Inst, Detroit, MI USA

[14] McGill Univ, Dept Surg, Div Urol, Montreal, PQ, Canada

[15] Next Fertil Procrea, Lugano, Switzerland

[16] Selcuk Univ, Dept Urol, Sch Med, Konya, Turkey

[17] Austin Fertil & Reprod Med Westlake IVF, Austin, TX USA

[18] King Abdulaziz Univ, Dept Urol, Jeddah, Saudi Arabia

[19] Minia Univ, Fac Med, Dept Urol, Al Minya, Egypt

[20] Loma Linda Univ Hlth, Dept Urol, Loma Linda, CA USA

[21] Istanbul Medipol Univ, Fac Med, Dept Urol, Istanbul, Turkey

[22] Univ Hlth Sci, Fatih Sultan Mehmet Training & Res Hosp, Dept Urol, Istanbul, Turkey

[23] Med Univ Innsbruck, Dept Urol, Innsbruck, Austria

[24] Pusan Natl Univ, Dept Urol, Sch Med, Busan, South Korea

[25] Pusan Natl Univ Hosp, Med Res Inst, Busan, South Korea

[26] Case Western Reserve Univ, Univ Hosp, Urol Inst, Cleveland, OH 44106 USA

[27] Imperial Coll, Dept Surg & Canc, Div Surg, London, England

[28] Univ Foggia, Dept Urol & Organ Transplantat, Osped Riuniti Foggia, Foggia, Italy

[29] SENSART Clin, Istanbul, Turkey

[30] Istanbul Univ, Istanbul Fac Med, Dept Urol, Sect Androl, Istanbul, Turkey

[31] Univ Queensland, Princess Alexandra Hosp, Dept Urol, Brisbane, Qld, Australia

[32] Univ Catania, Urol Sect, Catania, Italy

[33] Ctr Univ Saude ABC, Dept Urol, Santo Andre, SP, Brazil

[34] Ideia Fertil Inst Human Reprod, Androl Grp, Santo Andre, SP, Brazil

[35] Imperial Coll London, Dept Reprod Endocrinol & Androl, London, England

[36] Hammersmith Hosp, Dept Androl, London, England

[37] St Marys Hosp, Dept Androl, London, England

[38] Lilavati Hosp & Res Ctr, Dept Urol, Div Androl, Mumbai, Maharashtra, India

来源：

WORLD JOURNAL OF MENS HEALTH | 2023年 / 41卷 / 01期

关键词：

Antioxidants; Male infertility; Meta-analysis; Pregnancy; Semen parameters; Sperm DNA fragmentation; OLIGO-ASTHENO-TERATOZOOSPERMIA; SPERM DNA FRAGMENTATION; DOUBLE-BLIND; OXIDATIVE STRESS; VITAMIN-E; DHA SUPPLEMENTATION; CARNITINE THERAPY; FATTY-ACIDS; LIVE-BIRTH; FOLIC-ACID;

D O I：

10.5534/wjmh.220067

中图分类号：

R69 [泌尿科学（泌尿生殖系疾病）];

学科分类号：

摘要：

Purpose: Seminal oxidative stress (OS) is a recognized factor potentially associated with male infertility, but the efficacy of antioxidant (AOX) therapy is controversial and there is no consensus on its utility. Primary outcomes of this study were to investigate the effect of AOX on spontaneous clinical pregnancy, live birth and miscarriage rates in male infertile patients. Secondary outcomes were conventional semen parameters, sperm DNA fragmentation (SDF) and seminal OS.Materials and Methods: Literature search was performed using Scopus, PubMed, Ovid, Embase, and Cochrane databases. Only randomized controlled trials (RCTs) were included and the meta-analysis was conducted according to PRISMA guidelines.Results: We assessed for eligibility 1,307 abstracts, and 45 RCTs were finally included, for a total of 4,332 infertile patients. We found a significantly higher pregnancy rate in patients treated with AOX compared to placebo-treated or untreated controls, without significant inter-study heterogeneity. No effects on live-birth or miscarriage rates were observed in four studies. A significantly higher sperm concentration, sperm progressive motility, sperm total motility, and normal sperm morphology was found in patients compared to controls. We found no effect on SDF in analysis of three eligible studies. Seminal levels of total antioxidant capacity were significantly higher, while seminal malondialdehyde acid was significantly lower in patients than controls. These results did not change after exclusion of studies performed following varicocele repair.Conclusions: The present analysis upgrades the level of evidence favoring a recommendation for using AOX in male infertility to improve the spontaneous pregnancy rate and the conventional sperm parameters. The failure to demonstrate an increase in live-birth rate, despite an increase in pregnancy rates, is due to the very few RCTs specifically assessing the impact of AOX on live-birth rate. Therefore, further RCTs assessing the impact of AOX on live-birth rate and miscarriage rate, and SDF will be helpful.

引用

页码：14 / 48

页数：35

共 94 条

[11] The efficacy of antioxidants in sperm parameters and production of reactive oxygen species levels during the freeze-thaw process: A systematic review and meta-analysis
Bahmyari, Rezvan
Zare, Morteza
Sharma, Rakesh
Agarwal, Ashok
Halvaei, Iman
[J]. ANDROLOGIA, 2020, 52 (03)
[12] Placebo-controlled double-blind randomized trial on the use of L-carnitine, L-acetylcarnitine, or combined L-carnitine and L-acetylcarnitine in men with idiopathic asthenozoospermia
Balercia, G
Regoli, F
Armeni, T
Koverech, A
Mantero, F
Boscaro, M
[J]. FERTILITY AND STERILITY, 2005, 84 (03) : 662 - 671
[13] Coenzyme Q10 treatment in infertile men with idiopathic asthenozoospermia: a placebo-controlled, double-blind randomized trial
Balercia, Giancarlo
Buldreghini, Eddi
Vignini, Arianna
Tiano, Luca
Paggi, Francesca
Amoroso, Salvatore
Ricciardo-Lamonica, Giuseppe
Boscaro, Marco
Lenzi, Andrea
Littarru, GianPaolo
[J]. FERTILITY AND STERILITY, 2009, 91 (05) : 1785 - 1792
[14] Oxidative stress and male infertility: current knowledge of pathophysiology and role of antioxidant therapy in disease management
Barati, Erfaneh
Nikzad, Hossein
Karimian, Mohammad
[J]. CELLULAR AND MOLECULAR LIFE SCIENCES, 2020, 77 (01) : 93 - 113
[15] Barekat F, 2016, INT J FERTIL STERIL, V10, P120
[16] Boonyarangkul Arthit, 2015, Journal of the Medical Association of Thailand, V98, P1057
[17] Reactive oxygen species impact on sperm DNA and its role in male infertility
Bui, A. D.
Sharma, R.
Henkel, R.
Agarwal, A.
[J]. ANDROLOGIA, 2018, 50 (08)
[18] Effect of metabolic and antioxidant supplementation on sperm parameters in oligo-astheno-teratozoospermia, with and without varicocele: A double-blind placebo-controlled study
Busetto, G. M.
Agarwal, A.
Virmani, A.
Antonini, G.
Ragonesi, G.
Del Giudice, F.
Micic, S.
Gentile, V.
De Berardinis, E.
[J]. ANDROLOGIA, 2018, 50 (03)
[19] Busetto GM, 2017, HUM REPROD, V32, P142
[20] Effects of N-acetylcysteine on Semen Parameters and Oxidative/Antioxidant Status
Ciftci, Halil
Verit, Ayhan
Savas, Murat
Yeni, Ercan
Erel, Ozcan
[J]. UROLOGY, 2009, 74 (01) : 73 - 76

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