Utility of Antioxidants in the Treatment of Male Infertility: Clinical Guidelines Based on a Systematic Review and Analysis of Evidence
It is widely accepted that oxidative stress plays an important role in the pathophysiology of male infertility and that antioxidants could have a significant role in the treatment of male infertility. The main objectives of this study are: 1) to systematically review the current evidence for the u...
Main Authors: | , , , , , , , , , , , , , , |
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Format: | Article |
Language: | English |
Published: |
Korean Society for Sexual Medicine and Andrology
2021-04-01
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Series: | The World Journal of Men's Health |
Subjects: |
Summary: | It is widely accepted that oxidative stress plays an important role in the pathophysiology of male infertility and that antioxidants
could have a significant role in the treatment of male infertility. The main objectives of this study are: 1) to systematically review
the current evidence for the utility of antioxidants in the treatment of male infertility; and 2) propose evidence-based clinical
guidelines for the use of antioxidants in the treatment of male infertility. A systematic review of the available clinical evidence was
performed, with articles published on Scopus being manually screened. Data extracted included the type of antioxidant used,
the clinical conditions under investigation, the evaluation of semen parameters and reproductive outcomes. The adherence to the
Cambridge Quality Checklist, Cochrane Risk of Bias for randomized controlled trials (RCTs), CONSORT guidelines and JADAD
score were analyzed for each included study. Further, we provided a Strength Weakness Opportunity Threat (SWOT) analysis to
analyze the current and future value of antioxidants in male infertility. Of the 1,978 articles identified, 97 articles were included
in the study. Of these, 52 (53.6%) were uncontrolled (open label), 12 (12.4%) unblinded RCTs, and 33 (34.0%) blinded RCTs,
whereas 44 (45.4%) articles tested individual antioxidants, 31 (32.0%) a combination of several products in variable dosages, and
22 (22.6%) registered antioxidant products. Based on the published evidence, we 1) critically examined the necessity of additional
double-blind, randomized, placebo-controlled trials, and 2) proposed updated evidence-based clinical guidelines for antioxidant
therapy in male infertility. The current systematic review on antioxidants and male infertility clearly shows that antioxidant
supplementation improves semen parameters. In addition, it provides the indications for antioxidant treatment in specific clinical
conditions, including varicocele, unexplained and idiopathic male infertility, as well as in cases of altered semen quality. |
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ISSN: | 2287-4208 2287-4690 |