Effect of vitamin E administered to men in infertile couples on sperm and assisted reproduction outcomes: a double-blind randomized study

Abstract

Objective: To evaluate the influence on sperm parameters and in vitro fertilization (IVF) outcomes of the administration of 400 mg/day of vitamin E for 3 months to men from infertile couples who are undergoing IVF. Design: Double-blind, placebo-controlled, randomized study. Setting: Human reproduction unit of a university hospital. Patient(s): A total of 101 couples, 50 in the vitamin E group and 51 in the placebo group, undergoing IVF, among whom 64.4% of cases had an abnormal spermiogram according to World Health Organization (WHO) criteria. Intervention(s): Vitamin E (a-tocopherol), 400 mg daily by mouth for 3 months, with sperm analysis performed immediately before starting the treatment and 3 months later on the day of IVF. Main Outcome Measure(s): WHO sperm parameters and IVF outcomes. Result(s): Although there was a statistically significant increase in progressive motility in the vitamin E group compared with beforetreatment values, a similar increase occurred in the placebo group. Normal morphology was even better in the placebo group. Regarding IVF outcomes, better fertilization rates were observed in the placebo group, but the live-birth rate per transfer was statistically significantly higher in the vitamin E group: 17 (41.46%) of 41 versus 9 (20.46%) of 44 in the placebo group. Although the clinical pregnancy rates (both per transfer and per cycle started) and the implantation rate were somewhat higher in the vitamin E group (43.9% and 25%; 36.0% and 22.0%; and 24.7% and 14.1%, respectively), the increase was not statistically significant. Conclusion(s):The effect of vitamin E on classic sperm parameters was not an improvement over placebo. Nonetheless, vitamin E administration was associated with a statistically significantly higher live-birth rate, and there was a trend toward better results in other IVF parameters.

Calcium Homeostasis in the Epididymal Microenvironment: Is Extracellular Calcium a Cofactor for Matrix Gla Protein-Dependent Scavenging Regulated by Vitamins

“…Vitamins D and E are lipid-soluble antioxidants and known to have protective effects on sperm quality and DNA integrity in rats challenged with oxidative stress ( Greco et al, 2005 ; Momeni and Eskandari, 2012 ). While vitamin E administration alone in men of infertile couples did not improve sperm parameters upon conventional sperm analysis ( Matorras et al, 2020 ), it did so when used in combination with selenium ( Keskes-Ammar et al, 2003 ). Regarding vitamin K, the endocrine function of the vitamin K-dependent Ca 2+ -binding protein osteocalcin in male reproduction has been reported ( Karsenty, 2011 ; Oury et al, 2011 ; Oury et al, 2013 ; Patti et al, 2013 ).…”

Effect of Paternal Diet on Spermatogenesis and Offspring Health: Focus on Epigenetics and Interventions with Food Bioactive Compounds

“…Lower serum α-tocopherol levels have been found in men with oligozoospermia and asthenozoospermia [ 36 ]. Matorras et al (2020) showed that vitamin E supplementation (400 mg α-tocopherol/day) for three months was positively associated with live birth rate and a trend towards better results in in vitro fertilization parameters, but it did not significantly increase progressive sperm cell motility in a double-blind, placebo-controlled, randomized study [ 39 ]. In another clinical trial with infertile men, Keskes-Ammar et al (2003) demonstrated that daily supplementation with vitamin E (400 mg) and selenium (225 μg) for three months improved sperm cell motility and decreased lipid peroxidation in sperm cell and seminal plasma [ 40 ].…”

Antioxidant trials—the need to test for stress

“…The paper recently published in Human Reproduction Open by Joseph et al (2020) is one of a series of clinical trials which have been published in the past 12 months that purport to show little impact of antioxidant therapy on pregnancy rates ( Matorras et al ., 2020 ; Schisterman et al , 2020 ; Steiner et al , 2020 ). All of these trials have been well intentioned and carefully conducted however they all suffer from the same fundamental flaw which calls into question the validity of the conclusions reached ( Aitken, 2020a , b ).…”