Antioxidants for male subfertility

Area of Science:

• Reproductive Medicine and Endocrinology
• Male Infertility and Subfertility
• Oxidative Stress and Antioxidant Therapy

Background:

• Male factor infertility affects 10-15% of couples globally, with oxidative stress implicated in 25-87% of cases.
• Oral antioxidants are explored as a low-cost intervention to improve sperm quality by reducing oxidative damage.
• Current evidence on the effectiveness and regulation of antioxidants for male subfertility is uncertain.

Purpose of the Study:

• To evaluate the effectiveness and safety of oral antioxidant supplementation in subfertile men.
• To compare benefits and risks of various antioxidants used for male subfertility.

Main Methods:

• Systematic review and meta-analysis of randomized controlled trials (RCTs).
• Searched multiple databases (CGF, CENTRAL, MEDLINE, Embase, PsycINFO, CINAHL) up to February 2018.
• Included RCTs comparing oral antioxidants with placebo or no treatment in subfertile men; primary outcome was live birth.

Main Results:

• Low-quality evidence suggests antioxidants may increase live birth rates (OR 1.79) and clinical pregnancy rates (OR 2.97).
• No significant increase in miscarriage rates was observed, but mild gastrointestinal upsets may occur (OR 2.51).
• Evidence quality is low to very low due to risk of bias, poor reporting, and small sample sizes; comparisons between different antioxidants were inconclusive.

Conclusions:

• Antioxidant supplementation may offer potential benefits for live birth and clinical pregnancy rates in subfertile men.
• The current evidence is inconclusive due to significant limitations in study quality and reporting.
• Large, well-designed RCTs are required to establish the definitive role of antioxidants in male subfertility management.