Antioxidants are widely used for men with abnormal sperm results. However, recent study shows that they are of no benefit.
What are antioxidants?
As our body processes the food we eat or interact with our environment, our body cells produces waste products called free radicals or reactive oxygen species (ROS). Our body also produces antioxidants to remove the excess ROS and maintain the balance. There can be various reasons why this balance can be lost and the level of ROS rise. If the ROS level increases, it can cause various diseases like heart disease, cancer and also affect sperm count, motility, DNA integrity and its ability to fertilise egg.
Factors that increase ROS level in semen are infection (Urine, prostate infection), varicocele, smoking, and exposure to UV rays, pollution and pesticides.
Though antioxidants like Vitamin A, C, E, selenium, manganese, Nacetylcysteine, carnitine are available from various fruits and vegetables, they are also marketed as supplements to treat male factor infertility. The supplements can be bought without prescription or online and been used worldwide by men with abnormal sperm results.
What kind of study is this?
It is a multi-centre randomised controlled trial conducted in United States. Randomised controlled study is considered to be the best type of research to know if the treatment is effective. It was conducted at nine hospitals in United States.
Men participating in the study were allocated randomly to receive antioxidant or placebo (no drug).
Who are the people this study is meant for?
This study is meant for men ≥18 years who have failed to conceive for 12 months and who had abnormal sperm results (low count 5-15million/ml, motility<40%, normal forms <1% and DNA fragmentation>25%).
However, those with very low sperm count (<5 million/ml) or on fertility treatment were excluded.
So, what are the findings?
85 men received the antioxidants and 86 men received placebo.
Treatment lasted for 3-6 months. – Couples attempted to conceive naturally for first 3 months and then with IUI + clomiphene for next 3 months.
There were no change in the sperm count, motility, DNA fragmentation after 3 months of antioxidant treatment
There was no difference of pregnancy rate in the two groups either. Taking antioxidants did not increase the chances of getting pregnant.
Why is this study important?
So far research showed some benefit of having antioxidants in men with abnormal sperm results. However, the most of the studies done previously were small. Some included men with both normal sperm and with abnormal sperm. Most of the studies were in men having IVF.
Hence this study was needed.
Antioxidants are currently given to men with abnormal sperm results without checking their ROS level. Men can also buy them online or from supermarkets without prescription.
However, excessive use of antioxidants can also upset the balance and cause harm.
What should I do then?
It is better to get the antioxidants from natural sources like fruits and vegetables. Most fruits and vegetables are rich in antioxidants. Below are some examples:
Fruits - apples, grapes, berries, pomegranates, oranges, mango, melon and papaya.
Vegetables - rich in antioxidants are bell peppers, green leafy vegetables, carrot, peas, and tomatoes, corn.
In addition, dairy products, eggs, lentils, nuts and legumes like kidney beans are also rich in antioxidants.
Antioxidant supplements should ideally be given by your doctor and after measuring ROS level in the semen sample. However, measuring ROS level in sperm is not widely available. ROS levels can be measured using a chemiluminescence assay in specific lab.
Written by: Dr Anupa Nandi
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