Antioxidant Supplements and Male Infertility

Antioxidant supplements are commercially available to help treat male infertility, but research on their effects on semen quality and rates of pregnancy and live birth are limited.

The researchers conducted a multicenter, double-blind, randomized, placebo-controlled trial to determine whether antioxidants improve male fertility, as measured by semen parameters and DNA fragmentation at 3 months and pregnancy resulting in live birth after up to 6 months of treatment, among couples with male factor infertility. They found that antioxidant supplements do not improve semen quality among men with infertility. The study also found that antioxidant supplements likely do not improve pregnancy and live birth rates. The study appears in Fertility and Sterility.

The new study reports on results from the Males, Antioxidants, and Infertility Trial (MOXI), a double-blind, randomized, placebo-controlled clinical study conducted at nine sites across the United States. The study enrolled 171 couples where the male partner had at least one abnormal reading on an analysis evaluating sperm concentration, mobility, shape, and DNA quality; the female partners had normal fertility test results. Men received a placebo or an antioxidant supplement containing:

• Vitamins C, E, and D
• Selenium
• L-carnitine
• Zinc
• Folic acid
• Lycopene

for at least three months and up to six months. MOXI was supported by NICHD's Reproductive Medicine Network.

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The study team found no statistically significant differences in sperm concentration, mobility, shape, and DNA quality between the placebo and antioxidant groups after three months. Furthermore, live birth rates did not seem to differ at six months between the antioxidant (15%) and placebo (24%) groups. However, the authors note that per the study design, recruitment was stopped before it reached the desired number of participants because no benefits were seen in the antioxidant group. Therefore, the authors only had enough participants to evaluate statistical differences in semen quality but not in pregnancy and live birth rates.

According to the authors, MOXI is the largest randomized, placebo-controlled trial to examine the effects of antioxidants, without additional assisted reproductive technology, on male infertility.

WHO

Study author Esther Eisenberg, M.D., M.P.H., of NICHD's Fertility and Infertility Branch is available for interviews.

REFERENCE

Steiner AZ et al. The effect of antioxidants on male factor infertility: the Males, Antioxidants, and Infertility (MOXI) randomized clinical trial. Fertility and Sterility DOI: 10.1016/j.fertnstert.2019.11.008 (2020)