BACKGROUND Infertility affects about 15% of all couples worldwide. Male factors such as decreased semen quality contribute to around 40% of the cases. Recent reviews have shown that different foods and nutrients may improve semen quality. OBJECTIVES We conducted a systematic review in order to investigate whether intake of omega-3 fatty acids can improve semen quality markers. MATERIALS AND METHODS A systematic search of PubMed, Embase, and Cochrane was conducted in adherence with the PRISMA guideline from the earliest available online indexing year to October 2018. Keywords related to male fertility or infertility was combined with words describing omega-3 fatty acids and dietary fish intake. RCTs and observational studies on infertile and fertile men were included. Studies were considered eligible if they met the inclusion criteria, evaluated either the effect of omega-3 fatty acids or dietary fish intake and had semen quality as primary outcome. RESULTS Thousand and seventy four records were screened, and sixteen studies were ultimately included. Fourteen of the included studies found an improvement or association between omega-3 and at least one semen quality marker. As the studies were very inhomogeneous in participants (fertile/infertile, age, BMI, ethnicity etc), no meta-analysis was performed. DISCUSSION The findings in this review are limited by the few available RCTs. Furthermore, RCTs were very heterogenetic according to study population, sample size, dosage of omega-3, and durations of follow up. Results from the observational studies might have been affected by recall bias and confounded by lifestyle factors. CONCLUSION Based on the findings in this review, omega-3 supplements and dietary intake of omega-3 might improve semen quality parameters in infertile men and men from couples seeking fertility treatment. However, more research is required in order to fully clarify the effect of omega-3 on semen quality and research with fecundity as end point is needed.

https://onlinelibrary.wiley.com/doi/pdf/10.1111/andr.12649

The influence of omega-3 fatty acids on semen quality markers: a systematic PRISMA review.

Phosholipase A2 (PLA2 ) activity in the seminal plasma and in sperm heads is closely related to sperm motility and male fertility. Therefore, the purpose of this study was to investigate the possible involvement of different isoforms of phospholipase in asthenozoospermia. To accomplish this, cPLA2 , phospho-cPLA2 , iPLA2 , and sPLA2 were evaluated by immunofluorescence and immunoblot analyses in spermatozoa obtained from 22 normozoospermic men and 28 asthenozoospermic patients. We found significant differences in cPLA2 and its phosphorylated/activated form, iPLA2 , and sPLA2 content and distribution in normal and asthenozoospermic patients. cPLA2 was localized in heads, midpieces, and tails of all spermatozoa as constitutive enzyme, less expressed in the tail of spermatozoa with low progressive motility. While active phospho-cPLA2 distribution was homogeneous throughout the cell body of control-donor spermatozoa, lower levels were detected in the tails of asthenozoospermic patients, as opposed to its strong presence in heads. Low immunofluorescence signal for iPLA2 was found in astenozoospermic patients, whereas sPLA2 was significantly lower in the heads of asthenozoospermic patients. Spermatozoa with low progressive motility showed differences both in terms of total specific activity and of intracellular distribution. cPLA2 , iPLA2 , and sPLA2 specific activities correlated positively and in a significantly manner with sperm progressive motility both in normozoospermic men and asthenozoospermic patients. In conclusion, PLA2 s are expressed in different areas of human spermatozoa. Spermatozoa with low motility showed differences in total specific activity and enzyme distributions. We speculated that PLA2 expression and/or different distribution could be potential biomarkers of asthenozoospermia, one of the major causes of male factor infertility.

https://onlinelibrary.wiley.com/doi/pdf/10.1111/andr.12101

Asthenozoospermia and membrane remodeling enzymes: a new role for phospholipase A2.

The aim of this study was to investigate fatty acids composition of sperm phospholipids, level of lipoperoxidation represented by malondialdehyde and to examine differences between recent smokers and nonsmokers. The levels of malondialdehyde were in the group of all patients 1.51 ± 0.56 μmol l(-1) , in smokers 1.36 ± 0.59 μmol l(-1) and in nonsmokers 1.53 ± 0.55 μmol l(-1) . Total sperm membrane phospholipid fatty acids were profiled into several groups, saturated acids (in smokers 61.86 ± 9.02%, in nonsmokers 61.20 ± 11.66%), polyunsaturated acids n-3 (in smokers 12.62 ± 8.18%, in nonsmokers 14.28 ± 13.65%), polyunsaturated acids n-6 (in smokers 9.13 ± 4.37%, in nonsmokers 10.10 ± 3.79%) and other acids (in smokers 14.36 ± 3.94%, in nonsmokers 13.88 ± 2.31%). Significant correlations were found between the level of malondialdehyde (MDA) and total sperm motility in all patients (r = -0.358, P = 0.013), between both the level of MDA and progressive motility (r = -0.465, P = 0.001) and between the level of MDA and total motility (r = -0.382, P = 0.037) in nonsmokers. There were no statistically significant differences between composition of sperm phospholipid important fatty acids in smokers and nonsmokers. Significant correlations between selected sperm fatty acids and sperm motility and morphology in smokers and nonsmokers were not observed.

Effects of smoking on fatty acid composition of phospholipid sperm membrane and the malondialdehyde levels in human seminal plasma.

The study was conducted to determine the influence of D-aspartic acid (D-Asp) as antioxidant supplement and thawing rates on ram sperm motility, membrane integrity, abnormality, viability, mitochondria activity, malondialdehyde and antioxidant activities, and total antioxidant capacity after freezing-thawing process. Semen samples from five mature rams (3-4 years old) were diluted with extenders (1.5% soybean lecithin, 7% glycerol) containing no supplements (control) and D-Asp (5, 10, and 15 mg/L) and cryopreserved. Frozen straws were thawed at water bath temperatures at 37 ˚C for 30s and at 60 ˚C for 6s. Addition of 10 mg/L of D-Asp improved significantly progressive motility, average path velocity, and straight-line velocity percentages after freeze-thaw (P<0.05). Plasma membrane integrity, mitochondria activity, viability, total antioxidant capacity, and glutathione peroxidase were higher in group receiving 10 mg/L in comparison to other treatments (P<0.05). Meanwhile, total abnormality significantly decreased at this concentration (10 mg/L) in comparison to the level of 15 mg/L and control group (P<0.05). Our results revealed that malondialdehyde level was lower in group receiving 10 mg/L D-Asp compared to other treatments (P<0.05). There were no significant interactions between concentrations of D-Asp and thawing protocols for any semen samples. Also, significant improvement in sperm viability and mitochondria activity were observed at 37 ˚C to 30 s thawing method (P<0.05). In overall, results of the present study demonstrate that addition of D-Asp at level of 10 mg/L have beneficial effect on quality of post-thawed ram semen cryopreserved in an extender. Therefore, this antioxidant in the suitable dose can be recommended as an additional component of ram freezing extender. The 60 ˚C to 6s thawing procedure is not an appropriate replacement for 37 ˚C to 30 s.

https://ijas.iaurasht.ac.ir/article_665349_bc5e596ebac9d7a77cd2dd0b280d53ec.pdf

Effect of antioxidant D-aspartic acid and thawing rate on the freeze-thawing process of ram semen.

Background: The lipids of the spermatozoa membrane are important for the fluidity and flexibility of spermatozoa. However, spermatozoa’s lipids are the main substrates for peroxidation, which may provoke severe functional disorder of sperm. 
Objective: The aim of this study was to investigate the fatty acids composition of spermatozoa in men with asthenozoospermia, asthenoteratozoospermia and oligoasthenoteratozoospermia compared with normozoospermic males. 
Materials and Methods: A cross-sectional study was designed. The patients were 51 men with seminal parameters abnormalities undergoing infertility screening. The patients were grouped into asthenozoospermic (n=15), asthenoteratozoospermic (n=21) and oligoasthenoteratozoospermic (n=15). The patients were compared with 21 males with normozoospermia. Sperm fatty acid analysis was performed using capillary gas chromatography. 
Results: Levels of stearic acid and oleic acid were significantly higher in oligoasthenoteratozoospermic subjects compared with these levels in normozoospermic males. Levels of arachidonic acid and DHA were significantly lower in the sperms of oligoasthenoteratozoospermic males than normozoospermic men. Sperm motility and morphology were correlated positively with levels of arachidonic acid and DHA while a negative correlation was observed with levels of stearic acid and oleic acid.
Conclusion: In conclusion, impaired sperm function can originate from the disorder of sperm lipid metabolism. Low levels of DHA and arachidonic acid in spermatozoa of oligoasthenoteratozoospermic subjects may be the result of breakdown of them.

/pdf/fatty-acid-composition-in-normozoospermic-asthenozoopermic-3twwkgbzae.pdf

Nosratollah Zargham

Papers

Fatty acid composition in normozoospermic, asthenozoopermic,asthenoteratozoospermic and oligoasthenoteratozoospermic ejaculates