ICSI in cases of sperm DNA damage: beneficial effect of oral antioxidant treatment

Greco, Ermanno; Romano, Stefania; Iacobelli, Marcello; Ferrero, S.; Baroni, Elena; Minasi, Maria Giulia; Ubaldi, Filippo Maria; Rienzi, Laura; Tesařík, Jan

doi:10.1093/humrep/dei091

Cited by 230 publications

(103 citation statements)

References 32 publications

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“…The data obtained here illustrate clearly a marked improvement in the pregnancy and implantation rates at post-treatment ICSI cycle, which is most likely mediated by enhancement in sperm DNA integrity [26] [56]. This is concurrent with the observations reported by some studies [33] [34] [46]. Showell et al [28] published the Cochrane review on the basis of meta-analysis of 34 trials that included 2876 couples evaluating the effect of oral supplementation with antioxidants for male partners of couples undergoing ART.…”

Section: Discussionsupporting

confidence: 88%

“…Unlike, Tremellen et al [34] and Greco et al [46] studies found no effect of oral antioxidant supplements with Menevit and a combined Vitamin C + Vitamin E respectively, on embryo development despite a significant reduction in sperm DNA damage and a boost in pregnancy rates. Keeping in mind evidences supported above, it would be expected that if sperm chromatin is unable to decondense after entering the ooplasma, fertilization or post-fertilization failure could occur due to defective sperm DNA namely DNA fragmentation.…”

Section: Discussionmentioning

confidence: 85%

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Beneficial Effect of an Oral Antioxidant Supplementation (Fertimax2) on IVF-ICSI Outcomes: A Preliminary Clinical Study

Kacem¹,

Harzallah²,

Zedini³

et al. 2014

ARSci

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Background: Considerable evidence points towards a significant role of oxidative stress (OS) in the pathogenesis of sperm dysfunction. OS as a result of an inappropriate balance between oxidants and antioxidants in the semen can cause DNA damage and lipid peroxidation leading to failure of conception, miscarriage or potentially even childhood cancer. The objective of this study was to investigate whether a male antioxidant therapy can improve semen parameters and the results of in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI). Methods: A total of fortyeight infertile couples were considered. Male participants were administrated Fertimax2 antioxidant treatment for at least two months prior to their partner's IVF-ICSI cycle. Sperm parameters (volume, concentration, progressive motility) and the IVF-ICSI outcomes were compared before and after the antioxidant treatment. The primary outcome measures were oocyte fertilization, cleavage and good embryo quality rates; the secondary outcomes were biochemical pregnancies, clinical pregnancies and implantation rates. Results: The principal finding that emerged from this study was that antioxidant therapy resulted in significant improvements in fertilization (p = 00.2), cleavage (p = 0.004) and good-embryo quality (p = 0.002) rates accompanied by a marked increase in clinical pregnancy (18.7% versus 2.5%) and implantation (11.8% versus 1.02%) rates. No significant changes in routine sperm parameters were observed. Conclusion: The Fertimax2 antioxidant therapy appears to influence favorably chances of conception in couples undergoing assisted reproduction treatment (ART).

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 85%

Beneficial Effect of an Oral Antioxidant Supplementation (Fertimax2) on IVF-ICSI Outcomes: A Preliminary Clinical Study

Kacem¹,

Harzallah²,

Zedini³

et al. 2014

ARSci

View full text Add to dashboard Cite

show abstract

“…Oxidative stress is known to be an important factor that causes male infertility by damaging sperm DNA [606162]. Greco et al [63] found that patients who took antioxidants before an ICSI procedure did not show differences in the fertility rate, cleavage rate, or embryo morphology, but had higher clinical pregnancy and implantation rates. However, Tremellen et al [64] argued that the positive effects of antioxidant therapy on SDF caused by reactive oxygen species are limited and that sperm DNA damage remains high in many patients even after treatment.…”

Section: Treatment Strategies For Patients With High Levels Of Sdfmentioning

confidence: 99%

What should be done for men with sperm DNA fragmentation?

Kim

2018

Clin Exp Reprod Med

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In an age when a small quantity of sperm can lead to pregnancy through in vitro fertilization or intracytoplasmic sperm injection, selecting healthy sperm is important. Sperm DNA fragmentation (SDF) is known to be higher in infertile men. Terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick end labeling (TUNEL) and the alkaline comet test are SDF tests that directly measure DNA damage and have shown closer correlations with assisted reproduction results than indirect tools such as the sperm chromatin structure assay or the sperm chromatic dispersion test. It is difficult; however, to endorse a single test as the best test overall; instead, it is best to select a testing method based on each patient's clinical condition and goals. In a couple struggling with infertility, if the male partner has a high level of SDF, he should aim to decrease SDF through lifestyle modifications, antioxidant treatment, and ensuring an appropriate duration of abstinence, and physicians need to treat the underlying diseases of such patients. If sperm DNA damage continues despite the patient's and physician's efforts, other methods, such as micromanipulation-based sperm selection or testicular sperm extraction, should be used to select healthy sperm with nuclear DNA integrity.

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“…The results showed that antioxidants might have increased clinical pregnancy rates [odds ratios (OR): 3.43, P < 0.0001, 7 RCTs, 522 men] and live birth rates (OR: 4.21, P < 0.0001, 4 RCTs, 277 men), but these evidences were graded low. Representative oral antioxidant therapies are vitamin C alone (400-1000 mg/ day) [98] and a combination of vitamins C and E [99,100]. Vitamins C and E work synergistically, and many studies on the positive effect of combined antioxidants on reducing DNA fragmentation and increasing the clinical pregnancy rate have been reported.…”

Section: Oral Antioxidant Therapymentioning

confidence: 99%

Reactive Oxygen Species and Sperm Cells

Takeshima¹,

Kuroda²,

Yumura³

2018

Reactive Oxygen Species (ROS) in Living Cells

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Many cases of male factor infertility are idiopathic, but 30-40% of cases may have excessive levels of reactive oxygen species (ROS) in their semen. The origins of endogenous ROS are leukocytes and immature spermatozoa, and external causes are various. On the contrary, seminal plasma contains various antioxidants. Low levels of ROS are essential for the fertilization process, but excessive levels of ROS lead to oxidative stress and can have harmful effects such as lipid peroxidation of a membrane, sperm deoxyribonucleic acid fragmentation, and apoptosis on the fertile capacity. In order to evaluate oxidative stress appropriately, ROS is measured by the chemiluminescence method with neat semen and quantification of 8-OH-2′-deoxyguanosine and malondialdehyde in seminal plasma. Antioxidant potential is often measured using total antioxidant capacity (TAC) assay. The oxidation-reduction potential measured by a MiOXSYS analyzer is a novel, easier, quicker, and less expensive technology to measure oxidative stress. In order to minimize oxidative stress and improve clinical outcomes, sperm-sorting methods, lifestyle modifications, shortening the ejaculatory abstinence, and treatments such as oral antioxidants, varicocelectomy, and testicular sperm extraction are taken into account. As a future prospect, proteomics, metabolomics, and genomics are still developing areas that have the potential to discover new findings and highly sensitive biomarkers.

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ICSI in cases of sperm DNA damage: beneficial effect of oral antioxidant treatment

Abstract: Oral antioxidant treatment appears to improve ICSI outcomes in those patiens with sperm DNA damage, in whom this treatment reduces the percentage of damaged spermatozoa.

Cited by 230 publications

References 32 publications

Beneficial Effect of an Oral Antioxidant Supplementation (Fertimax2) on IVF-ICSI Outcomes: A Preliminary Clinical Study

Beneficial Effect of an Oral Antioxidant Supplementation (Fertimax2) on IVF-ICSI Outcomes: A Preliminary Clinical Study

What should be done for men with sperm DNA fragmentation?

Reactive Oxygen Species and Sperm Cells

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