The Effects of Combined Oral Antioxidants on Male Infertility

الملخص

Background
High reactive oxygen species (ROS) levels was considered as an important factor of male infertility that can result in DNA damage, decrease motility and damage membrane integrity. The role of antioxidants is to maintain the balance between ROS production and their clearance which improve sperm parameters and enhance male fertility.
Patients and methods
Sixty six male patients with median age of 29 years with a mean period of infertility of 1.5 year that attend the infertility clinic in Al-Diwaniya Maternity and Pediatric Hospital were selected randomly in this study which extend from January 2013 to October 2014 (22 months).The patients were selected to have idiopathic oligo-astheno-teratozoospermia, they underwent a detailed history, general and genital physical examination, Two semen analyses, baseline hormone profile and scrotal Doppler ultrasound examination . All patients were given a combination of oral antioxidants including vitamin E (400 IU. once daily), coenzyme Q10 ( 75 mg. tablet twice a day), zinc sulphate (15 mg. tablet three time a day) and L-carnitine ( 1000 mg. twice a day) for three months duration of treatment. Semen analysis was repeated after three months from initiation of therapy and was evaluated for changes in volume, concentration, motility and morphology in comparison with baseline semen analyses and any pregnancy was also documented.
Results
Thirteen patients (19%) get pregnancy after a period of 2 to 3 months, other patients show variable changes in their seminal analysis after 3 months. Thirty patients (45%) show increasing in seminal volume of 0.5 to 2 ml. , while the sperm concentration was increased in 28 patients(42%) . Twenty two patients (33%) show increasing in motility , morphology was increased in 34 patients (51%) .From all 66 patients; 6 patients (9 %) get improvement in all four parameters, while 9 patients (14 %) get improvement in only 3 parameters, 20 patients (30 %) get improvement in only 2 parameters, 23 patients (35 %) get improvement in only one parameter and 8 patients (12 %) had no improvement in any parameter.
Conclusion
This study demonstrates a possible role of combined oral antioxidants in the improvement of semen parameters and pregnancy rate for selected infertile men with superiority for the use of combination of antioxidants rather than single agent treatment.