UOS Physiopathology of Human Reproduction, IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
Eur Rev Med Pharmacol Sci. 2018 Oct;22(20):7078-7085. doi: 10.26355/eurrev_201810_16180.
Reduction in motility and number of spermatozoa and change in their morphology are some of the most relevant causes of male infertility. Production of reactive oxygen species may affect motility, morphology and DNA stability of spermatozoa. This study aimed at evaluating the effect of combined treatment with myo-inositol, alpha-lipoic acid, folic acid, betaine and vitamins (namely, Sinopol®) on semen parameters of sub-fertile men.
We recruited 143 sub-fertile men, 26-53 years aged, no-smokers, without any testicular pathologies, with a normal endocrinological/metabolic profile, and no concomitant consumption of drugs. Out of them, 25 patients did not meet study inclusion criteria mainly due to the history of genital diseases that came to light after Sinopol® prescription. Among the 118 men that fulfilled inclusion criteria, 10 (8.4%) patients were lost at follow-up and in 8 (6.8%) cases the partner got pregnant spontaneously. Thus, 100 patients completed the study and semen analysis was performed before and after 90 days of treatment.
Semen quality improved after 90 days of treatments, with a statistically significant increase of sperm concentration (p=0.0009), of number of spermatozoa (p=0.0017), of progressive motility (p=0.0047), of total motile sperm count (p=0.0010), and of normal sperm morphology (p<0.0001).
For the first time we reported that a combination of nutraceuticals composed of myo-inositol, alpha-lipoic acid, folic acid, betaine and vitamins improves sperm parameters in sub-fertile men. We are aware that to clarify the clinical relevance of the data studies with larger sample sizes and longer durations are needed, as well as evaluation of myo-inositol and alpha-lipoic acid co-treatment effectiveness in improving the chances to obtain a pregnancy spontaneously or following assisted reproduction.
精子活力和数量的减少以及形态的改变是男性不育的最主要原因之一。活性氧的产生可能会影响精子的活力、形态和 DNA 稳定性。本研究旨在评估肌醇、α-硫辛酸、叶酸、甜菜碱和维生素（即 Sinopol®）联合治疗对生育能力低下男性精液参数的影响。
我们招募了 143 名年龄在 26-53 岁之间的生育能力低下的男性，他们不吸烟，没有睾丸疾病，内分泌/代谢正常，没有同时服用药物。其中 25 名患者主要由于 Sinopol®处方后出现的生殖器疾病史不符合研究纳入标准。在符合纳入标准的 118 名男性中，有 10 名（8.4%）患者在随访时丢失，8 名（6.8%）患者的配偶自然怀孕。因此，共有 100 名患者完成了研究，并在治疗前和治疗 90 天后进行了精液分析。
治疗 90 天后精液质量得到改善，精子浓度（p=0.0009）、精子数（p=0.0017）、前向运动精子比例（p=0.0047）、总活力精子数（p=0.0010）和正常精子形态比例（p<0.0001）均有统计学显著增加。
我们首次报道了一种由肌醇、α-硫辛酸、叶酸、甜菜碱和维生素组成的营养补充剂组合可改善生育能力低下男性的精子参数。我们意识到，为了明确数据的临床相关性，需要进行更大样本量和更长时间的研究，以及评估肌醇和α-硫辛酸联合治疗对提高自然受孕或辅助生殖后受孕机会的效果。
