Department of Anatomy, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran.
Non-Communicable Diseases Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran.
Urol J. 2021 Sep 13;18(5):549-555. doi: 10.22037/uj.v18i.6325.
Male infertility accounts for about half of all infertility cases. Asthenoteratozoospermia is a severe form of male infertility. Free radicals play an important role in infertility. In a study we found that asthenoteratozoospermic men had a lower mean percentage of sperm HSPA2+ and higher intracellular anion superoxide than normozoospermia. Antioxidants are thought to be able to counteract the negative effects of free radicals. We explored the efficacy of vitamin E in combination with Se on the level of sperm HSPA2+, intracellular anion superoxide and chromatin integrity in these patients.
60 patients entered the study. They were randomized to treatment group of oral Se (200 μg) in combination with vitamin E (400 units) for 3 months (n= 30) or placebo (n= 30). Semen samples were obtained and assessed for sperm parameters, intracellular O2-, protamine deficiency, sperm HSPA2+ and apoptotic spermatozoa at baseline and after treatment phase.
There were no significant differences in baseline semen parameters, intracellular O2- protamine deficiency, sperm HSPA2+ and apoptotic spermatozoa between the treatment and placebo groups. There was a statistically significant decrease in sperm apoptosis and the level of anion superoxide (P=.001) and an increase in sperm motility and viability (P=.001) in the treated group, but no significant difference was found in the percentage of sperm HSPA2+ and sperm protamine deficiency compared with baseline. Moreover, no significant change was found in these parameters in placebo group after 3 months.
Our results showed that administration of vitamin E and selenium for three months may improve sperm motility and viability by decreasing intracellular anion superoxide and sperm apoptosis in asthenoteratozoospermic infertile men. We suggest that consuming these supplements before assisted reproductive technology (ART) may improve outcomes in these patients.
男性不育约占所有不育病例的一半。弱精子症是一种严重的男性不育症。自由基在不育症中起重要作用。在一项研究中，我们发现弱精子症患者的精子 HSPA2+平均百分比较低，而内源性阴离子超氧自由基水平较高。抗氧化剂被认为能够抵消自由基的负面影响。我们探讨了维生素 E 联合硒对这些患者精子 HSPA2+水平、内源性阴离子超氧自由基和染色质完整性的疗效。
60 名患者入组研究。他们被随机分为治疗组，口服硒（200μg）联合维生素 E（400 单位）治疗 3 个月（n=30）或安慰剂（n=30）。在基线和治疗阶段后，获取精液样本并评估精子参数、内源性 O2-、鱼精蛋白缺乏、精子 HSPA2+和凋亡精子。
治疗组和安慰剂组的基线精液参数、内源性 O2-、鱼精蛋白缺乏、精子 HSPA2+和凋亡精子无显著差异。治疗组精子凋亡和阴离子超氧自由基水平显著下降（P=.001），精子活力和活力显著增加（P=.001），但与基线相比，精子 HSPA2+百分比和精子鱼精蛋白缺乏无显著差异。此外，安慰剂组在 3 个月后这些参数无明显变化。
我们的结果表明，维生素 E 和硒治疗 3 个月可通过降低内源性阴离子超氧自由基和精子凋亡来改善弱精子症不育男性的精子活力和活力。我们建议在辅助生殖技术（ART）前服用这些补充剂可能会改善这些患者的结局。
