A Global Survey of Reproductive Specialists to Determine the Clinical Utility of Oxidative Stress Testing and Antioxidant Use in Male Infertility

被引:27
作者
Agarwal, Ashok [1 ]
Finelli, Renata [1 ]
Selvam, Manesh Kumar Panner [1 ,2 ]
Leisegang, Kristian [3 ]
Majzoub, Ahmad [4 ,5 ]
Tadros, Nicholas [6 ]
Ko, Edmund [7 ]
Parekh, Neel [8 ]
Henkel, Ralf [1 ,9 ,10 ]
Durairajanayagam, Damayanthi [11 ]
Colpi, Giovanni M. [12 ]
Cho, Chak Lam [13 ]
Sallam, Hassan N. [14 ]
Park, Hyun Jun [15 ,16 ]
Saleh, Ramadan [17 ]
Micic, Sava [18 ]
Ambar, Rafael F. [19 ,20 ]
Zini, Armand [21 ]
Tremellen, Kelton [22 ]
Alvarez, Juan G. [23 ]
Palani, Ayad [24 ]
Arafa, Mohamed [1 ,25 ,26 ]
Gava, Marcello M. [19 ,20 ]
Jindal, Sunil [27 ]
Amar, Edouard [28 ]
Kopa, Zsolt [29 ]
Moein, Mohammad Reza [30 ]
Busetto, Gian Maria [31 ]
Sengupta, Pallav [32 ]
Kavoussi, Parviz [33 ]
Maldonado, Israel [34 ]
Fikri, Jamal [35 ]
Borges, Edson [36 ]
Martinez, Marlon [37 ]
Bojovic, Djordje [38 ]
Rajmil, Osvaldo [39 ]
Aydos, Kaan [40 ]
Parekattil, Sijo [41 ,42 ]
Marmar, Joel L. [43 ]
Sefrioui, Omar [44 ]
Jungwirth, Andreas [45 ]
Rodriguez Pena, Marcelo Gabriel [46 ]
Cordts, Emerson B. [47 ]
Elbardisi, Haitham [4 ]
Mostafa, Taymour [26 ]
Sabbaghian, Marjan [48 ]
Gilani, Mohammad Ali Sadighi [48 ]
Morimoto, Yoshiharu [49 ]
Alves, Marco G. [50 ,51 ]
Spasic, Aleksandra [52 ]
机构
[1] Cleveland Clin, Amer Ctr Reprod Med, Mail Code X-11,10681 Carnegie Ave, Cleveland, OH 44106 USA
[2] Tulane Univ, Dept Urol, Hlth Sci Ctr, New Orleans, LA USA
[3] Univ Western Cape, Sch Nat Med, Cape Town, South Africa
[4] Hamad Med Corp, Dept Urol, Doha, Qatar
[5] Weill Cornell Med Qatar, Doha, Qatar
[6] Southern Illinois Univ, Div Urol, Sch Med, Springfield, IL USA
[7] Loma Linda Univ Hlth, Dept Urol, Loma Linda, CA USA
[8] Cleveland Clin, Dept Urol, Cleveland, OH USA
[9] Imperial Coll London, Dept Metab Digest & Reprod, London, England
[10] Univ Western Cape, Dept Med Biosci, Bellville, South Africa
[11] Univ Teknol MARA, Fac Med, Sungai Buloh Campus, Shah Alam, Selangor, Malaysia
[12] Procrea Inst, Androl & IVF Unit, Lugano, Switzerland
[13] Chinese Univ Hong Kong, SH Ho Urol Ctr, Dept Surg, Hong Kong, Peoples R China
[14] Alexandria Univ, Fac Med, Alexandria, Egypt
[15] Pusan Natl Univ, Dept Urol, Sch Med, Busan, South Korea
[16] Pusan Natl Univ Hosp, Med Res Inst, Busan, South Korea
[17] Sohag Univ, Fac Med, Dept Dermatol Venereol & Androl, Sohag, Egypt
[18] Uromed Polyclin, Androl Dept, Belgrade, Serbia
[19] Fac Med ABC, Dept Urol, Sexual & Reprod Med, Santo Andre, Brazil
[20] Ideia Fertil Inst Human Reprod, Androl Grp, Santo Andre, SP, Brazil
[21] McGill Univ, Dept Surg, St Marys Hosp, Montreal, PQ, Canada
[22] Flinders Univ S Australia, Dept Obstet Gynaecol & Reprod Med, Bedford Pk, SA, Australia
[23] Ctr ANDROGEN, La Coruro, Spain
[24] Univ Garmian, Coll Med, Dept Biochem, Kalar, Iraq
[25] Hamad Med Corp, Doha, Qatar
[26] Cairo Univ, Fac Med, Dept Androl Sexol & STIs, Cairo, Egypt
[27] Jindal Hosp, Dept Androl & Reprod Med, Meerut, Uttar Pradesh, India
[28] Amer Hosp Paris, Cabinet Androl Victor Hugo, Reprod Ctr, Paris, France
[29] Semmelweis Univ, Androl Ctr, Dept Urol, Budapest, Hungary
[30] Yazd Res & Clin Ctr Infertil, Yazd, Iran
[31] Univ Foggia, Dept Urol & Renal Transplantat, Policlin Riuniti Foggia, Foggia, Italy
[32] MAHSA Univ, Fac Med Biosci & Nursing, Dept Physiol, Kuala Lumpur, Malaysia
[33] Austin Fertil & Reprod Med Westlake IVF, Austin, TX USA
[34] IVF Lab, Citmer Reprod Med, Mexico City, DF, Mexico
[35] Al Boustane Clin, IVF Unit, Rabat, Morocco
[36] Sapientiae Inst, Fertil Med Grp, Sao Paulo, Brazil
[37] Univ Santo Tomas Hosp, Dept Urol, Manila, Philippines
[38] GAO Bojovic, Belgrade, Serbia
[39] Fundacio Puigvert, Dept Androl, Barcelona, Spain
[40] Univ Ankara, Dept Urol, Ankara, Turkey
[41] Avant Concierge Urol, Winter Garden, FL USA
[42] Univ Cent Florida, Winter Garden, FL USA
[43] Cooper Univ Hosp, Camden, NJ USA
[44] Anfa Fertil Ctr, Casablanca, Morocco
[45] St Barbara Clin, Bad Vigaun, Austria
[46] Inst Ginecol & Fertilidad IFER, Androl Unit, Buenos Aires, DF, Argentina
[47] Fac Med ABC, Human Reprod Ctr, Inst Ideia Fertil, Sao Paulo, SP, Brazil
[48] ACECR, Royan Inst Reprod Biomed, Dept Androl, Reprod Biomed Res Ctr, Tehran, Iran
[49] HORAC Grand Front Osaka Clin, IVF Japan Grp, Osaka, Japan
[50] Univ Porto, Inst Biomed Sci Abel Salazar ICBAS, Dept Anat, Porto, Portugal
关键词
Antioxidants; Male infertility; Oxidative stress; Reproduction; physicians; Survey; SPERM DNA-DAMAGE; SEMEN PARAMETERS; VITAMIN-E; FRAGMENTATION; SUPPLEMENTATION; GUIDELINE; DIAGNOSIS; QUALITY; MEN;
D O I
10.5534/wjmh.210025
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: The use of antioxidants is common practice in the management of infertile patients. However, there are no established guidelines by professional societies on antioxidant use for male infertility. Materials and Methods: Using an online survey, this study aimed to evaluate the practice pattern of reproductive specialists to determine the clinical utility of oxidative stress (OS) testing and antioxidant prescriptions to treat male infertility. Results: Responses from 1,327 participants representing 6 continents, showed the largest participant representation being from Asia (46.8%). The majority of participants were attending physicians (59.6%), with 61.3% having more than 10 years of experience in the field of male infertility. Approximately two-thirds of clinicians (65.7%) participated in this survey did not order any diagnostic tests for OS. Sperm DNA fragmentation was the most common infertility test beyond a semen analysis that was prescribed to study oxidative stress-related dysfunctions (53.4%). OS was mainly tested in the presence of lifestyle risk factors (24.6%) or sperm abnormalities (16.3%). Interestingly, antioxidants were prescribed by 85.6% of clinicians, for a duration of 3 (43.7%) or 3-6 months (38.6%). A large variety of antioxidants and dietary supplements were prescribed, and scientific evidence were mostly considered to be modest to support their clinical use. Results were not influenced by the physician's age, geographic origin, experience or training in male infertility. Conclusions: This study is the largest online survey performed to date on this topic and demonstrates 1) a worldwide understanding of the importance of this therapeutic option, and 2) a widely prevalent use of antioxidants to treat male infertility. Finally, the necessity of evidence-based clinical practice guidelines from professional societies is highlighted.
引用
收藏
页码:470 / 488
页数:19
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