The effect of vitamin C on the gene expression profile of sperm protamines in the male partners of couples with recurrent pregnancy loss: A randomized clinical trial

Hamidian, Saeideh; Talebi, Ali Reza; Fesahat, Farzaneh; Bayat, Mohammad; Mirjalili, Ali; Ashrafzadeh, Hamid Reza; Rajabi, Mahya; Montazeri, Fateme

doi:10.5653/cerm.2019.03188

Cited by 15 publications

(16 citation statements)

References 48 publications

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“…A total of 21 articles published between January 2019 and July 2020 investigated the effects of antioxidant treatment on semen quality ( Table 4 ) [ 25 42 43 44 45 46 56 57 92 93 94 95 96 97 98 99 100 101 104 115 121 ]. Based on our analysis, 13 and 8 studies were ranked as low and high-quality, respectively.…”

Section: Resultsmentioning

confidence: 99%

“…Furthermore, Terai et al [ 98 ] did not include a placebo group, with an experimental group investigating a Chinese herbal formula. Hadi et al [ 45 ], Alahmar et al [ 97 ], Hamidian et al [ 121 ], Salehi et al [ 42 ], Hasoon [ 43 ], Gambera et al [ 93 ], Arafa et al [ 25 ], Nazari et al [ 101 ], and Jannatifar et al [ 92 ] all reported improved semen parameters, but these studies are uncontrolled open label trials and are relatively underpowered. Furthermore, Alkumait et al [ 100 ] and Terai et al [ 98 ] were unblinded trials with relatively small sample sizes (n=51 and 31, respectively).…”

Section: Critical Evaluation Of the Necessity Of Additional Double-blmentioning

confidence: 99%

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Utility of Antioxidants in the Treatment of Male Infertility: Clinical Guidelines Based on a Systematic Review and Analysis of Evidence

Agarwal

Leisegang

Majzoub

et al. 2021

World J Mens Health

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It is widely accepted that oxidative stress plays an important role in the pathophysiology of male infertility and that antioxidants could have a significant role in the treatment of male infertility. The main objectives of this study are: 1) to systematically review the current evidence for the utility of antioxidants in the treatment of male infertility; and 2) propose evidence-based clinical guidelines for the use of antioxidants in the treatment of male infertility. A systematic review of the available clinical evidence was performed, with articles published on Scopus being manually screened. Data extracted included the type of antioxidant used, the clinical conditions under investigation, the evaluation of semen parameters and reproductive outcomes. The adherence to the Cambridge Quality Checklist, Cochrane Risk of Bias for randomized controlled trials (RCTs), CONSORT guidelines and JADAD score were analyzed for each included study. Further, we provided a Strength Weakness Opportunity Threat (SWOT) analysis to analyze the current and future value of antioxidants in male infertility. Of the 1,978 articles identified, 97 articles were included in the study. Of these, 52 (53.6%) were uncontrolled (open label), 12 (12.4%) unblinded RCTs, and 33 (34.0%) blinded RCTs, whereas 44 (45.4%) articles tested individual antioxidants, 31 (32.0%) a combination of several products in variable dosages, and 22 (22.6%) registered antioxidant products. Based on the published evidence, we 1) critically examined the necessity of additional double-blind, randomized, placebo-controlled trials, and 2) proposed updated evidence-based clinical guidelines for antioxidant therapy in male infertility. The current systematic review on antioxidants and male infertility clearly shows that antioxidant supplementation improves semen parameters. In addition, it provides the indications for antioxidant treatment in specific clinical conditions, including varicocele, unexplained and idiopathic male infertility, as well as in cases of altered semen quality.

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Section: Resultsmentioning

confidence: 99%

Section: Critical Evaluation Of the Necessity Of Additional Double-blmentioning

confidence: 99%

Utility of Antioxidants in the Treatment of Male Infertility: Clinical Guidelines Based on a Systematic Review and Analysis of Evidence

Agarwal

Leisegang

Majzoub

et al. 2021

World J Mens Health

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show abstract

“…It has been associated with improvements in semen quality in a dose-dependent manner in smokers [ 35 ], whereas the main benefits seem to lie on motility [ 36 ]. Furthermore, meaningful effects of vitamin C administration on DNA quality and mRNA levels on the semen of patients with recurrent pregnancy loss have been observed [ 37 ]. In patients with varicocele, increased oxidative stress markers have been found to be negatively associated with the concentration of vitamin C in the internal spermatic vein [ 38 ].…”

Section: Discussionmentioning

confidence: 99%

Vitamins as primary or adjunctive treatment in infertile men with varicocele: A systematic review

Tsampoukas

Gkeka

Dellis

et al. 2021

Arab Journal of Urology

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Objective: To investigate the usage and the efficacy of vitamins as primary or adjuvant treatment in infertile men with varicocele. Methods: A systematic search in PubMed, the Medical Literature Analysis and Retrieval System Online (MEDLINE) and Cochrane Library with the terms (varicocele) AND (vitamins) was performed. We searched for studies: a) reporting the administration of vitamins (individually or as part of a complex) in men with varicocele and infertility, b) primarily or adjuvant to invasive treatment, and c) reporting the impact on semen parameters and/or pregnancy rates. Exclusion criteria were animal, adolescent and non-English studies, grey literature and trials reporting abstracts only. Results: Seven studies were identified eligible for qualitative analysis. All studies were randomised except one (case series). Vitamins were administered dominantly as part of antioxidant complex and only two studies used vitamins (C and E, respectively) as sole agent. In two studies, vitamin monotherapy resulted in improvement in semen quality, but the effect on pregnancy rates is unknown. One study reported no efficacy of adjuvant multivitamin treatment after embolisation in terms of both semen quality and pregnancy rates. Finally, four studies reported a positive effect of vitamins on semen parameters after varicocelectomy, but the effect on pregnancy rates is conflicting; one study reported improved pregnancy rates with adjuvant treatment, two studies did not evaluate the pregnancy rates, and in one study the outcome was unclear due to missing data. Conclusions: Vitamins have been used mostly as part of an antioxidant panel for the management of infertile men with varicocele. Most studies have found a positive impact on semen parameters in selected men with varicocele and infertility, as primary or adjuvant treatment. However, the clinical benefit of vitamins administration on pregnancy rate is under-evaluated and should be the target of future research.

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“…This randomized clinical trial was designed as an alternative investigation of our previous study that was registered in the Iranian Registry of Clinical with the national ID no. IRCT20180312039059N1 [ 18 ]. Twenty male partners of infertile couples with RPL due to male factor infertility were randomly selected among who referred to Yazd Research and Clinical Center for infertility using a random number table.…”

Section: Methodsmentioning

confidence: 99%

Impact of Vitamin C on Gene Expression Profile of Inflammatory and Anti-Inflammatory Cytokines in the Male Partners of Couples with Recurrent Pregnancy Loss

Fesahat

Norouzi

Seifati

et al. 2022

International Journal of Inflammation

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Immune system disorders and increased inflammation in the male reproductive system can lead to fetal risk in the early stages of development and implantation. Antioxidants such as vitamin C can play a protective role against sperm inflammatory reactions. This study aimed to evaluate the effect of vitamin C on the expression of inflammatory and anti-inflammatory cytokine genes in the male partners of couples with recurrent pregnancy loss. In this randomized clinical trial, twenty male partners of couples with RPL were examined for sperm parameters and expression profile of some inflammatory and anti-inflammatory cytokine genes before and after treatment with vitamin C. There was a statistically significant higher rate of normal morphology and sperm concentration in each patient before and after treatment with vitamin C p ≤ 0.05 . The mRNA levels of interleukin 6 and tumor necrosis factor-alpha were significantly decreased in the sperm of patients after treatment with vitamin C compared to before treatment. In contrast, the gene expression levels of interleukin 4 and transforming growth factor-beta showed a significant increase in the sperm of patients after treatment with vitamin C. Oral daily administration of vitamin C may be effective in the fertility potential of male partners of couples with RPL not only through the improvement of the sperm parameters but also by modulating the expression profile of inflammatory and anti-inflammatory genes. Further studies on protein levels are needed to clarify the role of TNF-⍺ and IFN-γ as a prognostic value in evaluating the recurrent abortion risk in infertile male partners. This trial is registered with IRCT20180312039059N1.

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The effect of vitamin C on the gene expression profile of sperm protamines in the male partners of couples with recurrent pregnancy loss: A randomized clinical trial

Cited by 15 publications

References 48 publications

Utility of Antioxidants in the Treatment of Male Infertility: Clinical Guidelines Based on a Systematic Review and Analysis of Evidence

Utility of Antioxidants in the Treatment of Male Infertility: Clinical Guidelines Based on a Systematic Review and Analysis of Evidence

Vitamins as primary or adjunctive treatment in infertile men with varicocele: A systematic review

Impact of Vitamin C on Gene Expression Profile of Inflammatory and Anti-Inflammatory Cytokines in the Male Partners of Couples with Recurrent Pregnancy Loss

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