Effect of Medicago sativa seed powder (Plus vitamin E vs. vitamin E alone) on semen analysis in men with idiopathic infertility: A double blind randomized clinical trial

The Effect of Dietary Supplements on Male Infertility in Terms of Pregnancy, Live Birth, and Sperm Parameters: A Systematic Review and Meta-Analysis

BACKGROUND/OBJECTIVES

The aim of this systematic review and meta-analysis was to investigate the effect of dietary supplements on male infertility.

METHODS

PubMed, Embase, and CENTRAL were searched from inception to May 2024. Randomized controlled trials with treatment durations of ≥12 weeks investigating the effect of dietary supplements on male infertility compared to placebo were included. Primary outcomes were pregnancy and live birth, while secondary outcomes were sperm concentration, sperm count, total motility, progressive motility, normal morphology, and DNA Fragmentation Index. Risk of bias was assessed using the revised Cochrane risk of bias (RoB2) tool. Data were meta-analyzed using random effects-restricted maximum likelihood models. Certainty of evidence was evaluated using the grading of recommendations, assessment, development and evaluation (GRADE) approach.

RESULTS

Of the 3137 articles identified, 50 were included. No effect on pregnancy and live birth was found. Different supplements improved single sperm parameters: Zinc and folic acid and ≥3 substance dietary supplements improved sperm concentration, selenium, carnitine, and coenzyme Q10 improved motility and alpha-lipoic acid improved normal morphology. Vitamin D, vitamin E, and omega-3 fatty acids showed no improvement in sperm parameters. The majority of studies had some concerns or high risk of bias, and certainty of evidence was generally low or very low.

CONCLUSIONS

This study found no convincing evidence of an effect of any dietary supplements on male infertility. Larger and more well-conducted randomized controlled trials focusing on specific supplements and considering pregnancy outcomes are needed.

From Hypoxia to Oxidative Stress: Antioxidants' Role to Reduce Male Reproductive Damage

Hypoxia is one of the main reasons causing male reproductive damage for people living in high altitude. Pathological evidences have been presented both in humans and animal models. Spermatogenesis disruption, worse sperm parameters, hormone disorder and erectile dysfunction are emblematic of male reproductive impairments brought by hypoxia. Among many mechanisms impairing male reproductive systems, oxidative stress is always a field of interest to explore. Although previous reviews have discussed about hypoxia or oxidative stress and antioxidants on male fertility respectively, no one has elucidated the concrete role of oxidative stress in hypoxia and correlating antioxidants that can ameliorate the negative effects. In this review, we firstly introduce hypoxia etiology and describe specific damage of hypoxia on male reproductive functions. Then, we emphasized interplays between hypoxia and oxidative stress as well as negative influences brought by oxidative stress. Finally, we listed antioxidants for oxidative stress and hypoxia-induced reproductive damage and discussed their controversial experimental effects for male infertility.