Salehi Peyman, Zahra Shahrokhi Seyedeh, Kamran Tayyebeh, Ajami Ali, Taghiyar Sana, Reza Deemeh Mohammad
Infertility center, Shahid Beheshti Hospital, Isfahan, Iran.
Department of Clinical Biochemistry, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
Int J Reprod Biomed. 2019 Mar 19;17(2):99-106. doi: 10.18502/ijrm.v17i2.3987. eCollection 2019 Feb.
The effect of antioxidant therapy on sperm DNA fragmentation index (DFI) and achieving natural pregnancy were under debate. Very few studies have showed the rate of pregnancy rate after the antioxidant therapy due to ethical and technical limitations.
The aim of this cohort study was to determine the improvement rate of sperm DFI and natural pregnancy rate after the antioxidant therapy in infertile men.
1645 infertile men were subjected for this study from May 2015 to December 2017. The Spermogram and sperm DFI were assessed using World Health Organization (WHO) 2010-based protocols and sperm chromatin structure assay (SCSA), respectively, in sperm samples before and after antioxidant therapy.
The total sperm DFI improvement rate was 38.9% in the total population. Sperm DFI improvement had close correlation with total motility (= 0.731, p= 0.001) and progressive motility improvement (= 0.885, p= 0.001); 16.8% of individuals who completed antioxidant therapy for nine months achieved natural pregnancy.
The results of the current study suggested that SCSA along with spermogram might be a suitable option for the evaluation of fertility potential. In addition, antioxidant therapy may be useful for men with high levels of sperm DFI. However, the rate of pregnancy was still low and other treatment protocols such as assisted reproductive technology may be necessary.
抗氧化治疗对精子DNA碎片化指数（DFI）及实现自然受孕的影响存在争议。由于伦理和技术限制，极少有研究表明抗氧化治疗后的妊娠率。
本队列研究旨在确定抗氧化治疗后不育男性精子DFI的改善率及自然妊娠率。
2015年5月至2017年12月，1645名不育男性参与本研究。分别采用基于世界卫生组织（WHO）2010标准的方案和精子染色质结构分析（SCSA），在抗氧化治疗前后的精液样本中评估精液分析和精子DFI。
总体人群中精子DFI总改善率为38.9%。精子DFI改善与总活力（= 0.731，p = 0.001）和前向运动力改善（= 0.885，p = 0.001）密切相关；完成9个月抗氧化治疗的个体中，16.8%实现了自然受孕。
本研究结果表明，SCSA与精液分析可能是评估生育潜力的合适选择。此外，抗氧化治疗可能对精子DFI水平高的男性有用。然而，妊娠率仍然较低，可能需要其他治疗方案，如辅助生殖技术。
