Bassiri Farzaneh, Tavalaee Marziyeh, Dattilio Maurizio, Nasr-Esfahani Mohammad Hossein
Department of Reproductive Biotechnology, Reproductive Biomedicine Research Center, Royan Institute for Biotechnology, ACECR, Isfahan, Iran.
R and D Department, Parthenogen, Piazza Indipendenza 11, Lugano 6900, Switzerland. Electronic Address:
Int J Fertil Steril. 2020 Apr;14(1):57-62. doi: 10.22074/ijfs.2020.6084. Epub 2020 Feb 25.
Micronutrients in support to the carbon cycle were shown to reduce sperm DNA damage both in animal models and infertile men. Besides supporting DNA methylation, their positive effect may be mediated by an improved performance of the endogenous antioxidant system but this has not yet been proven in clinical settings. The present study aimed at evaluating the effects of micronutrient supplementation in infertile male partners of assisted reproductive technology (ART) resistant couples.
In this experimental clinical trial study, infertile male partners of couples resistant to at least one ART cycle, with a sperm fragmentation rate >20% (TUNEL), underwent a 4-month oral supplementation with micronutrients in support to the carbon cycle including folates, B vitamins, zinc and cysteines. Semen, sperm DNA fragmentation (TUNEL), nuclear maturation (CMA3 and blue aniline staining) and lipid peroxidation (BODIPY) were assessed before and after treatment. The couples were followed-up to record clinical outcomes.
Forty-three patients completed the program but full data of pre- and post-treatment were available only for 25 patients. The treatment did not modify sperm concentration or motility but improved morphology. Nuclear maturation, DNA fragmentation and lipid peroxidation significantly improved after the treatment. Overall, 10 clinical pregnancies (23.3%) and 4 live births (9.3%) were recorded during the follow-up following expectant management (25 couples) or a new intracytoplasmic sperm injection (ICSI) cycle (18 couples).
The micronutrients appeared to induce both DNA methylation, resulting in improved sperm nuclear maturation, and antioxidant defences, resulting in less DNA fragmentation and lipid peroxidation. The clinical outcomes were aligned with a possible positive effect on reproductive function. Micronutrients could be regarded as an alternative to antioxidants in correcting oxidative damage in infertile men; however, to confirm such findings, further clinical investigations are warranted (Registration number: IRCT201510207223N6).
在动物模型和不育男性中，支持碳循环的微量营养素被证明可减少精子DNA损伤。除了支持DNA甲基化外，它们的积极作用可能是由内源性抗氧化系统性能的改善介导的，但这尚未在临床环境中得到证实。本研究旨在评估微量营养素补充对辅助生殖技术（ART）抵抗性夫妇的不育男性伴侣的影响。
在这项实验性临床试验研究中，对至少一个ART周期有抵抗性、精子碎片率>20%（TUNEL）的夫妇的不育男性伴侣，进行了为期4个月的口服补充支持碳循环的微量营养素，包括叶酸、B族维生素、锌和半胱氨酸。在治疗前后评估精液、精子DNA碎片（TUNEL）、核成熟（CMA3和蓝色苯胺染色）和脂质过氧化（BODIPY）。对夫妇进行随访以记录临床结果。
43名患者完成了该项目，但仅25名患者有完整的治疗前后数据。治疗未改变精子浓度或活力，但改善了形态。治疗后核成熟、DNA碎片和脂质过氧化显著改善。总体而言，在期待管理（25对夫妇）或新的卵胞浆内单精子注射（ICSI）周期（18对夫妇）后的随访期间，记录到10例临床妊娠（23.3%）和4例活产（9.
