Assisted Conception Unit, Guy's and St. Thomas' Hospital NHS Foundation Trust, 11th Floor Tower Wing, Guy's Hospital, St. Thomas Street, London SE19RT, UK.
Reprod Biomed Online. 2010 Jun;20(6):711-23. doi: 10.1016/j.rbmo.2010.03.008. Epub 2010 Mar 10.
The use of antioxidants in treatment of infertile men has been suggested, although the evidence base for this practice is unclear. A systematic review of randomized studies was conducted to evaluate the effects of oral antioxidants (vitamins C and E, zinc, selenium, folate, carnitine and carotenoids) on sperm quality and pregnancy rate in infertile men. MEDLINE, EMBASE, Cochrane Library and CINAHL were searched for relevant trials published from respective database inception dates to May 2009. Study selection, quality appraisal and data extraction were performed independently and in duplicate. Seventeen randomized trials, including a total of 1665 men, were identified, which differed in the populations studied and type, dosage and duration of antioxidants used. Only two-thirds of the studies (11/17) reported using allocation concealment and three studies (18%) used intention-to-treat analysis. Despite the methodological and clinical heterogeneity, 14 of the 17 (82%) trials showed an improvement in either sperm quality or pregnancy rate after antioxidant therapy. Ten trials examined pregnancy rate and six showed a significant improvement after antioxidant therapy. The use of oral antioxidants in infertile men could improve sperm quality and pregnancy rates. Adequately powered robust trials of individual and combinations of antioxidants are needed to guide clinical practice.
抗氧化剂在治疗男性不育中的应用已经被提出，尽管这种做法的证据基础尚不清楚。我们进行了一项系统评价，以评估口服抗氧化剂（维生素 C 和 E、锌、硒、叶酸、肉碱和类胡萝卜素）对不育男性精子质量和妊娠率的影响。我们在 MEDLINE、EMBASE、Cochrane 图书馆和 CINAHL 上检索了自各数据库建立日期至 2009 年 5 月发表的相关试验。研究选择、质量评估和数据提取均独立进行，并进行了重复。确定了 17 项随机试验，共纳入 1665 名男性，这些试验在研究人群以及使用的抗氧化剂类型、剂量和持续时间方面存在差异。只有三分之二的研究（11/17）报告了使用分配隐藏，三项研究（18%）使用了意向治疗分析。尽管存在方法学和临床异质性，但 17 项研究中的 14 项（82%）显示抗氧化剂治疗后精子质量或妊娠率有所改善。10 项试验检查了妊娠率，其中 6 项显示抗氧化剂治疗后有显著改善。口服抗氧化剂治疗不育男性可能会提高精子质量和妊娠率。需要进行足够数量的、强有力的、针对个体和联合抗氧化剂的试验，以指导临床实践。
