Delhi: A recent study has suggested that in couples with male factor infertility, antioxidants and their combinations are associated with improvement in semen volume, sperm concentration, and motility. However, the researchers found no differences in pregnancy rates between patients receiving carnitine, selenium, and coenzyme Q10, or placebo. The study was published in the journal Urology on 4 December 2021.
It is believed that male parther is contributory in half of all couples with infertility, however, the figure is likely to be an underetimate as men are less frequently evaluated in infertile couples. Oligo-astheno-terato-zoospermia (OAT) is the most common seminal abnormality in infertile men. These men are treated often with empirical therapies such as antioxidants. Thsi is based on assumption that OAT reulsts from oxidative stress (OS).
Several antioxidant are being used un male fertility. Studies evaluating these agents are met by some limitations including small sample size and heterogeneity. Rajeev Kumar, Professor of Urology, All India Institute of Medical Sciences, New Delhi, India, and colleagues therefore aimed to study the effect of three antioxidants viz. carnitine, selenium, and coenzyme Q10, alone or in combination, on both semen parameters and pregnancy rates in couples with male factor infertility.
For this purpose, the researchers performed a systematic search of the online databases for randomized studies comparing selenium, carnitine or coenzyme Q10 with placebo in the treatment of male infertility and reporting semen and pregnancy outcomes. Out of a total 3304 studies screened, 20 were included.
Based on the study, the researchers found the following:
Pregnancy rate in the treatment group (69/426, 16.2%) was not different from the placebo (45/401, 11.2%).
Treatment group showed higher motility [mean difference 5.05], progressive motility [mean difference 5.72], sperm concentration [mean difference 6.58] than placebo.
The researchers concluded that antioxidants and combos were associated with improvement in seminal parameters such as total motility, progressive motility, sperm concentration, and semen volume. However, the benefit was not significant for more clinically relevant parameters i.e. pregnancy outcomes.
"High heterogeneity and low quality of studies limit more robust analysis of the data," they wrote.
Reference:
The study titled, Systematic review and meta-analysis on effect of Carnitine, Coenzyme Q10 and Selenium on pregnancy and semen parameters in couples with idiopathic male infertility," was published in the journal Urology.
DOI: https://doi.org/10.1016/j.urology.2021.10.041