Title:Administration of Antioxidants in the Infertile Male: When it may have a Beneficial Effect?
Volume: 27
Issue: 23
Author(s): Zsolt Kopa*, Marton Keszthelyi and Nikolaos Sofikitis
Affiliation:
- Andrology Centre, Department of Urology, Semmelweis University, Budapest,Hungary
Keywords:
Antioxidants, male infertility, oxidative stress, reactive oxygen species, reductive stress, exogenous antioxidants.
Abstract:
Background: Reactive Oxygen Species (ROS) are required for intact spermatogenesis and sperm
function, but excessive levels will cause oxidative stress, impairing sperms and sperm function due to membrane
damage and DNA fragmentation.
Objective: Theoretically, antioxidant supplementation may act as a protection system against free radicals. Since
infertile males have higher levels of ROS, nutritional supplements are widely used for protecting sperms. In the
recent review, the authors summarize the most recent data regarding the effect of antioxidant treatment and draw
the attention of the limitations of antioxidant use in male infertility.
Methods: The recent review gives an update of antioxidant treatment in male infertility.
Results: Improvement of sperm parameters was reported in the majority of studies. Comparing different antioxidants
versus placebo showed low certainty of evidence with a serious risk of bias, and there is a lack regarding
certain doses, pregnancy rate, and live birth rate outcomes. Various clinical studies and randomized control trials
reported negative outcomes.
Conflicting findings lead the attention to the study of biochemical features of the oxidant vs. antioxidant equilibrium.
Higher exposure to antioxidants will result in “reductive stress”, which has harmful effects on sperm function,
moreover can negatively influence embryo development. Reductive stress is as dangerous as oxidative stress
and may act as a cause of different human pathologies.
Conclusion: An intact balance of oxidant and antioxidant systems is required for normal sperm function. No
guideline exists for the antioxidant dose regimen and treatment duration. Overdosing can result in reductive
stress, which is also harmful to fertility and can cause several diseases. Assessment of the pre-treatment redox
status can be recommended before the administration of exogenous antioxidants.
