TL;DR: It was showed that antioxidant supplements, especially a combination of antioxidants such as vitamin C, vitamin E, and CoQ10 intake can effectively improve semen parameters in infertile men.
Abstract: Many studies have focused on male infertility. There is limited evidence about the influence of nutrition on quality of semen. Approximately, 30-80% of infertility cases are caused by oxidative stress and decreased level of seminal total antioxidant capacity. This study was aimed to review the effects of oral antioxidant supplements on improving major semen parameters such as sperm concentration, motility, morphology, DNA damage, and fertility rate. Data were extracted from PubMed and Google scholar database by using the terms "antioxidant", "multivitamin", "carnitine", "CoQ10", "vitamin C", "vitamin E", "zinc", "folic acid", "N-acetyl cysteine" and "selenium" combined with "male infertility", "semen", and "sperm" to generate a set of relevant citations. Supplements such as CoQ10 and alpha-tocopherol significantly improve sperm count. Also, carnitine has positive effects on sperm motility and morphology. Simultaneous administration of vitamin E and vitamin C reduces the sperm DNA damage. However, in some studies, one or more factors have not changed substantially. In most of the studies, antioxidant supplementation improved the number, motility, morphology and sometimes DNA integrity of sperm. The present study showed that antioxidant supplements, especially a combination of antioxidants such as vitamin C, vitamin E, and CoQ10 intake can effectively improve semen parameters in infertile men.
TL;DR: In this article, the authors summarized the latest data on nutritional factors (specific food groups, nutrients, and nutritional supplements) that have an impact on female or male sexual and reproductive function.
Abstract: Infertility is defined as the inability to conceive after 12 months of unprotected intercourse or six months for women aged 35 years or older. The physical, emotional, psychological, and financial statuses of infertile couples are tremendously affected especially after undergoing diagnostic and/or curative treatments. Human fertility is influenced by multiple factors including female or male, and modifiable or non-modifiable factors. There is growing evidence that nutri-tion may play an important role in adjusting fertility-related outcomes in both men and women. The objective of our study was to summarize the latest data on nutritional factors (specific food groups, nutrients, and nutritional supplements) that have an impact on female or male sexual and reproductive function. PubMed and Google Scholar platforms were used to collect appropriate articles for the review using several combinations of keywords (infertility, diet, dietary supplements, antioxidants, and beverages). Adherence to a healthy dietary pattern favoring fish, poultry, whole grains, fruits, vegetables, and healthy fats, was related to better fertility in both genders. Despite the multifactorial etiology of sexual infertility, nutrition may affect the sexual/reproductive function in both women and men.
TL;DR: Troxerutin has protective effects on testicular torsion induced injury and can ameliorate spermatogenesis in the torsionsion-detorsion models.
Abstract: Background Troxerutin is a flavonoid antioxidant that protect different organ against damage caused by ischemia-reperfusion. Objective The aim of this study was to evaluate the effect of troxerutin in reducing the damages caused by ischemia-reperfusion in rat's testis. Materials and methods 40 Male Wistar rats (2 month old) were divide to four groups (n=10). Group1 (sham), Group 2 (control, ischemia-reperfusion (I/R) without treatment), Group 3 (I/R+150 mg/kg of troxerutin), and group 4 (I/R+20 mg/kg of vitamin C). Treatment of group 3 and group 4 during torsion (twists 720 counter clock at 90 min) followed by 50 days detorsion. After 50 days, blood samples were collected and rats in all study groups were killed and their testes were removed, and fixed with Bouin's solution. Testis was stained with hematoxylin and eosin dye and the level of testosterone, luteinizing hormone (LH) and follicle-stimulating hormone (FSH) were measured with ELISEA methods. TUNEL was employed to detect apoptosis. Epididymis caudal part was removed and total sperm count was determined. Johnson techniques were used for assessment of seminiferous tubules quality. Results Troxerutin treated group has higher Johnson score's (p≤0.001), antiapoptotic properties (p≤0.001), sperm count (p=0.065), and higher LH (p≤0.001), FSH (p≤0.001) and testosterone (p=0.002) levels than control group. Vitamin C treated group showed increase level of testosterone but didn't show significant differences on the number of apoptotic cells, Johnson scores, LH, FSH and sperm count than control group. Conclusion Troxerutin has protective effects on testicular torsion induced injury and can ameliorate spermatogenesis in the torsion-detorsion models.
9 citations
Cites background from "Antioxidant supplements and semen p..."
...Previous studies concluded that the use of oral antioxidant could improve sperm concentration (28)....
TL;DR: The oral intake of astaxanthin did not affect any semen parameters in patients with O±A±T, and statistically significant changes in the total number and concentration of spermatozoa were determined.
Abstract: Background Higher concentrations of seminal reactive oxygen species may be related to male infertility. Astaxanthin with high antioxidant activity can have an impact on the prevention and treatment of various health conditions, including cancer. However, efficacy studies on astaxanthin in patients with oligospermia with/without astheno- or teratozoospermia (O±A±T) have not yet been reported. Our aim was to evaluate the effect of the oral intake of astaxanthin on semen parameters. Patients and methods In a randomized double-blind trial, 80 men with O±A±T were allocated to intervention with 16 mg astaxanthin orally daily or placebo. At baseline and after three months basic semen parameters, sperm deoxyribonucleic acid (DNA) fragmentation and mitochondrial membrane potential (MMP) of spermatozoa and serum follicle-stimulating hormone (FSH) value were measured. Results Analysis of the results of 72 patients completing the study (37 in the study group, 35 in the placebo group) did not show any statistically significant change, in the astaxanthin group no improvements in the total number of spermatozoa, concentration of spermatozoa, total motility of spermatozoa, morphology of spermatozoa, DNA fragmentation and mitochondrial membrane potential of spermatozoa or serum FSH were determined. In the placebo group, statistically significant changes in the total number and concentration of spermatozoa were determined. Conclusions The oral intake of astaxanthin did not affect any semen parameters in patients with O±A±T.
TL;DR: This review article aims to present a comprehensive summary of how antioxidants, anti-inflammatory drugs and antibiotics treatment in reproductive tract infections are associated with amelioration of male fertility parameters.
Abstract: Male infertility is a multifactorial condition which in some cases are presented with unidentifiable underlying causes. Men with idiopathic or noncurable oligoasthenoteratozoospermia as well as with unexplained infertility may be provided with non-hormonal medical treatment which includes the use of anti-inflammatory, antioxidants, fibrinolytic compounds, vitamin supplementation, and oligo-elements, presuming that most of these cases are possibly caused by inflammation and/or oxidative stress. In the case of the known pathogenic mechanisms responsible for male infertility, the treatments include specific antibiotics targeting the exact pathogenic strains, anti-inflammatory drugs targeting particular infections, as well as the use of antioxidants, singly or in combinations to ameliorate the detected oxidative stress. Combined non-hormonal therapies have also shown to improve semen quality. Since there is a lack of consensus regarding the exact dose, duration and effects of non-hormonal treatment on male infertility, this review article aims to present a comprehensive summary of how antioxidants, anti-inflammatory drugs and antibiotics treatment in reproductive tract infections are associated with amelioration of male fertility parameters.
TL;DR: CoQ10 therapy of 6 months is a potential treatment for men with idiopathic OA and could potentially be used as diagnostic biomarkers for male fertility and predictors for pregnancy outcome and TTP in these patients.
Abstract: Different antioxidants including coenzyme Q10 (CoQ10) have been tried to treat idiopathic male infertility (IMI) with variable results. Therefore, this study aimed to determine the clinical and biochemical predictors of pregnancy outcome and time to pregnancy (TTP) in infertile men with idiopathic oligoasthenospermia (OA) pre‐ and post‐CoQ10 therapy. This prospective controlled clinical study included 178 male patients with idiopathic OA and 84 fertile men (controls). Patients received 200 mg of oral CoQ10 once daily for 6 months. Demographics, semen parameters, seminal CoQ10 levels, reactive oxygen species (ROS) levels, total antioxidant capacity (TAC), catalase (CAT), glutathione peroxidase (GPx), sperm DNA fragmentation (SDF) and body mass index were measured and compared at baseline and after 6 months. All participants were followed up for another 18 months for pregnancy outcome and TTP. CoQ10 therapy for 6 months significantly improved semen parameters, antioxidant measures and reduced SDF. The pregnancy rate was 24.2% and TTP was 20.52 ± 6.72 months in patients as compared to 95.2% and 5.73 ± 6.65 months in fertile controls. After CoQ10 therapy, CoQ10 level, sperm concentration, motility and ROS were independent predictors of pregnancy outcome and CoQ10 level, male age, sperm concentration, motility, ROS and GPx were independent predictors of TTP in patients. In conclusion, CoQ10 therapy of 6 months is a potential treatment for men with idiopathic OA. CoQ10 level, male age, semen parameters, ROS and GPx could potentially be used as diagnostic biomarkers for male fertility and predictors for pregnancy outcome and TTP in these patients.
TL;DR: Current knowledge on the function of vitamin E is summarized, with emphasis on its antioxidant vs. other properties, the preference of the organism for RRR‐α‐tocopherol, and its metabolism to CEHCs.
Abstract: Although vitamin E has been known as an essential nutrient for reproduction since 1922, we are far from understanding the mechanisms of its physiological functions. Vitamin E is the term for a group of tocopherols and tocotrienols, of which alpha-tocopherol has the highest biological activity. Due to the potent antioxidant properties of tocopherols, the impact of alpha-tocopherol in the prevention of chronic diseases believed to be associated with oxidative stress has often been studied, and beneficial effects have been demonstrated. Recent observations that the alpha-tocopherol transfer protein in the liver specifically sorts out RRR-alpha-tocopherol from all incoming tocopherols for incorporation into plasma lipoproteins, and that alpha-tocopherol has signaling functions in vascular smooth muscle cells that cannot be exerted by other forms of tocopherol with similar antioxidative properties, have raised interest in the roles of vitamin E beyond its antioxidative function. Also, gamma-tocopherol might have functions apart from being an antioxidant. It is a nucleophile able to trap electrophilic mutagens in lipophilic compartments and generates a metabolite that facilitates natriuresis. The metabolism of vitamin E is equally unclear. Excess alpha-tocopherol is converted into alpha-CEHC and excreted in the urine. Other tocopherols, like gamma- and delta-tocopherol, are almost quantitatively degraded and excreted in the urine as the corresponding CEHCs. All rac alpha-tocopherol compared to RRR-alpha-tocopherol is preferentially degraded to alpha-CEHC. Thus, there must be a specific, molecular role of RRR-alpha-tocopherol that is regulated by a system that sorts, distributes, and degrades the different forms of vitamin E, but has not yet been identified. In this article we try to summarize current knowledge on the function of vitamin E, with emphasis on its antioxidant vs. other properties, the preference of the organism for RRR-alpha-tocopherol, and its metabolism to CEHCs.
1,516 citations
"Antioxidant supplements and semen p..." refers background in this paper
...It also prevents lipid peroxidation and therefore improves functions of other antioxidants (24)....
TL;DR: This review will provide an overview of oxidative biochemistry related to sperm health and identify which men are most at risk of oxidative infertility, and outline methods available for diagnosing oxidative stress and the various treatments available.
Abstract: Oxidative stress occurs when the production of potentially destructive reactive oxygen species (ROS) exceeds the bodies own natural antioxidant defenses, resulting in cellular damage. Oxidative stress is a common pathology seen in approximately half of all infertile men. ROS, defined as including oxygen ions, free radicals and peroxides are generated by sperm and seminal leukocytes within semen and produce infertility by two key mechanisms. First, they damage the sperm membrane, decreasing sperm motility and its ability to fuse with the oocyte. Second, ROS can alter the sperm DNA, resulting in the passage of defective paternal DNA on to the conceptus. This review will provide an overview of oxidative biochemistry related to sperm health and will identify which men are most at risk of oxidative infertility. Finally, the review will outline methods available for diagnosing oxidative stress and the various treatments available.
1,231 citations
"Antioxidant supplements and semen p..." refers background in this paper
...Oxidative stress occurs when the production of reactive oxygen species (ROS) exceeds the body’s natural antioxidant defenses (6)....
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...These antioxidants neutralize free radical activity and protect sperm from ROS that already produced (6)....
TL;DR: This research aims to provide a more complete picture of the central nervous system and the role that emotion, disease and disease play in the development of chronic disease and its treatment.
661 citations
"Antioxidant supplements and semen p..." refers background in this paper
...Male factors account for at least 50% of all infertility cases worldwide (3)....
TL;DR: Extensive research in the Cleveland Clinic indicates that the seminal oxidative stress test has diagnostic and prognostic capabilities beyond those of conventional tests of sperm quality or functions and may be of particular importance to the future management of male infertility.
Abstract: Extensive research in our center at the Cleveland Clinic indicates that the seminal oxidative stress test has diagnostic and prognostic capabilities beyond those of conventional tests of sperm quality or functions. An oxidative stress test can accurately discriminate between fertile and infertile men and identify patients with a clinical diagnosis of male-factor infertility who are likely to initiate a pregnancy if they are followed over a period of time. In addition, the test can help select subgroups of patients with infertility in which oxidative stress is a significant factor, and who may benefit from antioxidant supplementation. Incorporation of such a test into routine andrology laboratory practice may be of particular importance to the future management of male infertility. In recent years, the generation of reactive oxygen species (ROS) in the male reproductive tract has become a real concern because of their potential toxic effects at high levels on sperm quality and function. ROS are highly reactive oxidizing agents belonging to the class of free radicals (Aitken, 1994). A free radical is defined as ‘‘any atom or molecule that possesses one or more unpaired electrons’’ (Warren et al, 1987). Recent reports have indicated that high levels of ROS are detected in semen samples of 25% to 40% of infertile men (de Lamirande et al, 1995; Padron et al, 1997). However, a strong body of evidence suggests that small amounts of ROS are necessary for spermatozoa to acquire fertilizing capabilities (Aitken, 1999). Spermatozoa, like all cells living in aerobic conditions, constantly face the oxygen (O2) paradox: O2 is required to support life, but its metabolites such as ROS can modify cell functions, endanger cell survival, or both (de Lamirande and Gagnon, 1995). Hence, ROS must be continuously inactivated to keep only a small
606 citations
"Antioxidant supplements and semen p..." refers background in this paper
...There are a number of studies that support the role of ROS in male infertility theory (8-11)....
TL;DR: The degradation of vitamin’C in mammals is initiated by the hydrolysis of dehydroascorbate to 2,3‐diketo‐l‐gulonate, which is spontaneously degraded to oxalate, CO2 and l‐erythrulose, at variance with bacteria such as Escherichia coli, which have enzymatic degradation pathways for ascorbate and probably also dehydroASCorbate.
Abstract: Vitamin C, a reducing agent and antioxidant, is a cofactor in reactions catalyzed by Cu(+)-dependent monooxygenases and Fe(2+)-dependent dioxygenases. It is synthesized, in vertebrates having this capacity, from d-glucuronate. The latter is formed through direct hydrolysis of uridine diphosphate (UDP)-glucuronate by enzyme(s) bound to the endoplasmic reticulum membrane, sharing many properties with, and most likely identical to, UDP-glucuronosyltransferases. Non-glucuronidable xenobiotics (aminopyrine, metyrapone, chloretone and others) stimulate the enzymatic hydrolysis of UDP-glucuronate, accounting for their effect to increase vitamin C formation in vivo. Glucuronate is converted to l-gulonate by aldehyde reductase, an enzyme of the aldo-keto reductase superfamily. l-Gulonate is converted to l-gulonolactone by a lactonase identified as SMP30 or regucalcin, whose absence in mice leads to vitamin C deficiency. The last step in the pathway of vitamin C synthesis is the oxidation of l-gulonolactone to l-ascorbic acid by l-gulonolactone oxidase, an enzyme associated with the endoplasmic reticulum membrane and deficient in man, guinea pig and other species due to mutations in its gene. Another fate of glucuronate is its conversion to d-xylulose in a five-step pathway, the pentose pathway, involving identified oxidoreductases and an unknown decarboxylase. Semidehydroascorbate, a major oxidation product of vitamin C, is reconverted to ascorbate in the cytosol by cytochrome b(5) reductase and thioredoxin reductase in reactions involving NADH and NADPH, respectively. Transmembrane electron transfer systems using ascorbate or NADH as electron donors serve to reduce semidehydroascorbate present in neuroendocrine secretory vesicles and in the extracellular medium. Dehydroascorbate, the fully oxidized form of vitamin C, is reduced spontaneously by glutathione, as well as enzymatically in reactions using glutathione or NADPH. The degradation of vitamin C in mammals is initiated by the hydrolysis of dehydroascorbate to 2,3-diketo-l-gulonate, which is spontaneously degraded to oxalate, CO(2) and l-erythrulose. This is at variance with bacteria such as Escherichia coli, which have enzymatic degradation pathways for ascorbate and probably also dehydroascorbate.