Antioxidants for male subfertility

Area of Science:

• Reproductive Medicine and Andrology
• Oxidative Stress and Male Infertility
• Nutritional Supplementation and Fertility

Background:

• Oxidative stress significantly contributes to male subfertility, affecting 30-80% of cases.
• Oral antioxidant supplementation is a common and inexpensive approach for men seeking to improve fertility.
• Pentoxifylline, an antioxidant-like drug, was also considered in this review.

Purpose of the Study:

• To evaluate the effectiveness of oral antioxidant supplementation in subfertile males.
• To assess the safety of antioxidant supplementation for male fertility.
• To analyze outcomes for couples seeking fertility assistance.

Main Methods:

• Conducted a comprehensive search of multiple databases up to January 2014, with an update in August 2014.
• Included 48 randomized controlled trials (RCTs) involving 4179 subfertile men, comparing antioxidants with placebo or no treatment.
• Primary outcome was live birth; secondary outcomes included clinical pregnancy, miscarriage, and adverse events. Evidence quality was assessed using GRADE.

Main Results:

• Antioxidants may increase live birth rates (OR 4.21, 95% CI 2.08 to 8.51) with low-quality evidence.
• Clinical pregnancy rates may also increase (OR 3.43, 95% CI 1.92 to 6.11), based on low-quality evidence.
• Insufficient evidence exists regarding miscarriage rates and gastrointestinal upsets due to very low-quality data.

Conclusions:

• Low-quality evidence suggests potential benefits of antioxidant supplementation for live birth and clinical pregnancy rates in subfertile men.
• Uncertainty remains regarding miscarriage risk and other adverse effects due to limited data.
• Further large, well-designed randomized placebo-controlled trials are essential to confirm these findings and clarify safety.