Antioxidant treatment of patients with asthenozoospermia or moderate oligoasthenozoospermia with high-dose vitamin C and vitamin E: a randomized, placebo-controlled, double-blind study

Abstract

In a randomized, placebo-controlled, double-blind study we investigated whether high-dose oral treatment with vitamins C and E for 56 days was able to improve semen parameters of infertile men. Ejaculate parameters included semen volume, sperm concentration and motility, and sperm count and viability. Thirty-one patients without genital infection but with asthenozoospermia (< 50% motile spermatozoa) and normal or only moderately reduced sperm concentration (> 7 x 10(6) spermatozoa/ml) (according to WHO criteria) were examined. To investigate the influence of the epididymal storage period on semen parameters, the patients were asked to deliver two semen samples with abstinence times of 2 and 7 days both before and at the end of vitamin treatment. After randomization, the patients received either 1000 mg vitamin C and 800 mg vitamin E (n = 15) or identical placebo capsules (n = 16). No changes in semen parameters were observed during treatment, and no pregnancies were initiated during the treatment period. Combined high-dose antioxidative treatment with vitamins C and E did not improve conventional semen parameters or the 24-h sperm survival rate. Prolonged abstinence time increased ejaculate volume (P < 0.05), sperm count (P < 0.05), sperm concentration (P < 0.05) and the total number of motile spermatozoa (P < 0.05).

The role of antioxidant therapy in the treatment of male infertility: an overview

“…In 1996, Geva et al 30 conducted a prospective study on 15 antiretroviral therapy patients, in which the administration of 200 mg day 21 for 3 months produced no changes in sperm morphology. Similarly, Rolf et al 31 found no positive effects after the administration of a combination of vitamins C and E (1000 and 800 mg daily) for 56 days, with no increase in motility, viability, concentration and morphology in any of the 33 asthenozoospermic patients who participated in the study.…”

“…However, only a few of the studies in this review evaluated this outcome, and no definitive answers have yet emerged from these trials. Fifteen in vivo studies 31,36,41,47,50,51,[62][63][64][65][66][67]69,76,82 included pregnancy rate among the end points measured; in two of these studies, a higher pregnancy rate was achieved, but was not statistically significant. 47,76 In another two studies, the pregnancy rate was lower in the antioxidant-treated group than in the control group, although the comparison was against clomiphene citrate or mesterolone rather than placebo.…”

“…As reported above, Rolf et al 31 found no effects on motility, viability, concentration or morphology in 33 asthenozoospermic patients after 56 days of therapy with 1000 mg of vitamin C and 800 mg of vitamin E. The role of antioxidant therapy in the treatment of male infertility F Lombardo et al 693…”

“…Only four of these studies [28][29][30][31] found little or no effect on semen parameters, whereas beneficial effects were reported in the remaining 18 studies. 8,19,[32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47] In vitro studies.…”

“…Kessopoulou et al, 1995 28 No effects (600 mg day 21 for 3 months, in vivo) Moilanen and Hovatta, 1995 29 No effects (600-1200 mg day 21 for 3 weeks, in vivo) Geva et al, 1996 30 No effects (200 mg day 21 for 3 months, in vivo) Vezina et al, 1996 35 Increased motility, morphology, viability; no effects on concentration (400 mg day 21 1 100-200 mg day 21 Se for 6 months, in vivo) Suleiman et al, 1996 36 Increased pregnancy rate, increased motility, reduced lipid peroxidation (300 mg day 21 for 6 months, in vivo) Kodama et al, 1997 37 Increased concentration, reduced DNA damage (200 mg vitamin C1200 mg vitamin E1GSH 400 mg every day for 2 months, in vivo) Hughes et al, 1998 38 Reduced DNA damage after Percoll preparation (30-60 mmol l 21 vitamin E, in vitro) Hughes et al, 1998 38 Increased DNA damage after Percoll preparation (300-600 mmol l 21 vitamin C1 30-60 mmol l 21 vitamin E, in vitro) Twigg et al, 1998 19 No effects on NADPH-induced lipid peroxidation (1 mmol l 21 , in vitro) Donnelly et al, 1999 39,40 Reduced H 2 O 2 -induced ROS production and DNA damage (40-60 mmol l 21 , in vitro) Rolf et al, 1999 31 No effects (800 mg vitamin E11000 mg vitamin C daily for 56 days, in vivo) Comhaire et al, 2000 41 Reduced ROS quantity; no effects on semen parameters (30 b-carotene1180 mg vitamin E daily for 3 months, in vivo) 38 Increased DNA damage after Percoll preparation (300-600 mmol l 21 vitamin C1 30-60 mmol l 21 vitamin E, in vitro) Verma and Kanwar, 1998 34 Preserved motility (800 mmol l 21 , in vitro) Donnelly et al, 1999 39,40 Reduced H 2 O 2 -induced ROS production and DNA damage (300-600 mmol l 21 , in vitro) Rolf et al, 1999 31 No effects (800 mg day 21 vitamin E11000 mg day 21 To be continued…”