Molecular Reproductive Medicine, Department of Translational Medicine, Lund University, Malmö, Sweden.
Reproductive Medicine Centre, Skåne University Hospital, Malmö, Sweden.
Andrology. 2018 Nov;6(6):811-816. doi: 10.1111/andr.12547. Epub 2018 Oct 8.
Previous reports on effect of antioxidants on sperm DNA integrity were equivocal, and there is a lack of randomized, placebo-controlled studies.
To evaluate the efficacy of combined antioxidant treatment in subfertile men with normal reproductive hormone levels and high sperm DNA fragmentation index (DFI).
This placebo-controlled, double-blind, randomized study evaluated the effects of combined antioxidant treatment in 77 men from infertile couples, with normal testosterone, LH and FSH levels and DFI ≥25%. All participants were randomly assigned to receive combined antioxidant treatment (vitamins, antioxidants and oligoelements) or placebo for six months. The primary outcome measured was DFI. Secondary outcomes were standard semen parameters. DFI and other semen parameters were, at each time point (pre-treatment, and after three and six months of treatment), compared between the treatment and the placebo group using Mann-Whitney U-test.
Antioxidant group had higher sperm concentration after three months of treatment (median: 24.4 × 10 /mL vs. 27.2 × 10 /mL; P = 0.028) and borderline statistically significant higher concentration after six months of treatment (median: 24.4 × 10 /mL vs. 33.3 × 10 /mL; P = 0.053) compared to pre-treatment values. The DFI did not change during the 6 months of antioxidant therapy. No statistically significant difference between the antioxidant and placebo group was seen for any of the semen parameters including sperm DFI at any of the three time points.
The increase in sperm concentration was more pronounced in the antioxidant treated group but not statistically significantly higher than among controls, perhaps due to insufficient statistical power. Previous studies have shown positive effect of antioxidant treatment on DFI and other semen parameters. However, our findings indicate that men with normal reproductive hormone levels may not be the primary target group for such therapy.
Six months treatment with antioxidants had no effect on sperm DFI.
以往关于抗氧化剂对精子 DNA 完整性影响的报告结果并不一致，且缺乏随机、安慰剂对照研究。
评估联合抗氧化治疗对生殖激素水平正常且精子 DNA 碎片化指数（DFI）较高的不育男性的疗效。
这项安慰剂对照、双盲、随机研究评估了联合抗氧化治疗对 77 名来自不育夫妇、睾酮、LH 和 FSH 水平正常且 DFI≥25%的男性的影响。所有参与者均随机分为接受联合抗氧化治疗（维生素、抗氧化剂和微量元素）或安慰剂组，治疗时间为 6 个月。主要结局测量指标为 DFI。次要结局指标为标准精液参数。在每个时间点（治疗前、治疗 3 个月和 6 个月后），使用 Mann-Whitney U 检验比较治疗组和安慰剂组的 DFI 和其他精液参数。
抗氧化治疗组在治疗 3 个月后精子浓度更高（中位数：24.4×10 6 /mL 比 27.2×10 6 /mL；P=0.028），治疗 6 个月后浓度也略有升高（中位数：24.4×10 6 /mL 比 33.3×10 6 /mL；P=0.053），与治疗前相比。在抗氧化治疗 6 个月期间，DFI 没有变化。在任何 3 个时间点，抗氧化组和安慰剂组之间的任何精液参数，包括精子 DFI，均无统计学显著差异。
抗氧化治疗组的精子浓度增加更为明显，但与对照组相比无统计学显著升高，这可能是由于统计效力不足。先前的研究表明抗氧化治疗对 DFI 和其他精液参数有积极影响。然而，我们的研究结果表明，生殖激素水平正常的男性可能不是这种治疗的主要目标人群。
6 个月的抗氧化治疗对精子 DFI 没有影响。
