Role of Micronutrients in Infertile Males Having Abnormal Semen Parameter
Published: 2023-08-17
Page: 187-196
Issue: 2023 - Volume 6 [Issue 1]
Kazi Khadeza Farhin *
Department of Reproductive Endocrinology and Infertility, Dhaka Medical College Hospital, Dhaka, Bangladesh.
Umma Salma
Department of Reproductive Endocrinology and Infertility, Dhaka Medical College Hospital, Dhaka, Bangladesh.
Nilufar Sultana
Department of Reproductive Endocrinology and Infertility, Dhaka Medical College Hospital, Dhaka, Bangladesh.
Nazneen Rahman
Department of Gynecology and Obstertrics, Kurmitola General Hospital, Dhaka, Bangladesh.
*Author to whom correspondence should be addressed.
Abstract
Background: Abnormal semen parameter is the most common cause of infertility in men. Approximately 15% of human couples are infertile and male sub fertility accounts for 50% of cases. About 90% of male factor infertility is idiopathic with no identifiable cause. Affected males has a definite detectable abnormality related to infertility, such as endocrine disease 1-3%, antisperm antibodies 3-13%, varicocele 25.4%, genetic cause 10-15%. A large number of recent studies have focused on the ability of nutraceuticals, to improve the hormonal status and sperm parameters by different mechanisms. Considering the positive effects of micronutrients on sperm motility and count a mixture of micronutrients applied to reverse the sperm parameters.
Objectives: To assess the efficacy of micronutrients regarding improvement of sperm count and motility with abnormal semen parameter.
Methods: It was a prospective observational study. This study was performed in Reproductive Endocrinology and Infertility Unit of Dhaka Medical College Hospital for one year. Study population consist of all the diagnosed case of infertile males having abnormal semen parameter between 25 to 50 years of age at DMCH. A total of 100 infertile males with abnormal semen parameter were selected for this study but finally 70 infertile male were included. A full assessment includes demographic information and baseline semen analysis. Then antioxidant was given one tablet in the morning and another at evening for three months and follow up semen analysis was done at prefixed schedule after three months to analysis the changes that was achieved.
Then pre-treatment and post treatment semen parameters, including sperm count and sperm motility were assessed. Statistical analyses were carried out by using the statistical package for social sciences version 22.0 for windows (SPSS Ins, Chicago, Illinois, USA).
Main outcome measure(s): Changes in sperm count and motility.
Results: The mean age was 40.5±5.9 years with ranged from 25 to 50 years. The Mean sperm count was found 12.34±1.84 mill/mL pre-treatment and 15.50±4.69 mill/mL post-treatment which was statistically significant (p<0.05). The mean rapid progression was found 28.84±20.77 pre-treatment and 47.44±25.02 post-treatment which was statistically significant (p<0.05). The mean non-progressive sperm was found 40.34±21.12 percent before treatment and 28.32±15.47 percent after treatment which was significantly decreased after micronutrient therapy (p<0.05). The improvement of semen parameters after treatment was 72.86%.
Conclusion: Majority of the male patients suffer from infertility due to Oligozoospermia and asthenozoospermia. Advance age, smoking and industrial workers were more common. Sperm count, sperm motility and rapid progression had significantly improved after three months of treatment. Therefore, this study suggests that micronutrients can be helpful to improve the sperm count and motility of infertile male having abnormal semen parameter.
Keywords: Oligozoospermia, asthenozoospermia, infertility, micronutrients, antioxidant
How to Cite
References
Salma U, Gill HK, Keith LG, Tilmon S, Jones CA, Sobti A, Patel A. Male subfertility and the role of micronutrient supplementation: Clinical and economic issues. Journal of Experimental & Clinical Assisted Reproduction. 2011;8.
Begum MR, Miller D, Salam MA, Quadir E, Begum MS, Khan F, Bhuiyan ZH. Antibiotics and Micronutritional Blend to Enhance Fertility Potential in Male Having Abnormal Semen Parameters. The Open Clinical Trials Journal. 2009;1(1).
Isidori AM, Pozza C, Gianfrilli D, Isidori A. Medical treatment to improve sperm quality. Reproductive biomedicine online. 2006;12(6):704-14.
Williams EA, Parker M, Robinson A, Pitt S, Pacey AA. A randomized placebo-controlled trial to investigate the effect of lactolycopene on semen quality in healthy males. European Journal of Nutrition. 2020;59:825-33.
Almujaydil MS. The Role of Dietary Nutrients in Male Infertility: A Review. Life. 2023;14;13(2):519.
Garolla A, Petre GC, Francini-Pesenti F, De Toni L, Vitagliano A, Di Nisio A, Foresta C. Dietary supplements for male infertility: a critical evaluation of their composition. Nutrients. 2020;12(5):1472.
Chavarro JE, Toth TL, Sadio SM, Hauser R. Soy food and isoflavone intake in relation to semen quality parameters among men from an infertility clinic. Human reproduction. 2008;23(11):2584-90.
Tielemans E, Burdorf A, te Velde ER, Weber RF, van Kooij RJ, Veulemans H, Heederik DJ. Occupationally related exposures and reduced semen quality: a case-control study. Fertility and sterility. 1999;71(4):690-6.
Ajayi VD, Ajayi AB, Ramesh B, Afolabi BM, Biobaku O, Oyetunji I. Comparative Analysis of Hysteroscopic Findings among infertile Women in Nigeria and in India: a Preliminary Investigation. J Gynecol Women’s Health. 2017;6(2):555681.
Sikka SC. Relative impact of oxidative stress on male reproductive function. Current medicinal chemistry. 2001 Jun 1;8(7):851-62.
Armstrong JS, Rajasekaran M, Hellstrom WJ, SIKKA SC. Antioxidant potential of human serum albumin: role in the recovery of high quality human spermatozoa for assisted reproductive technology. Journal of Andrology. 1998;19(4):412-9.
Sasano N, Ichijo S. Vascular patterns of the human testis with special reference to its senile changes. The Tohoku Journal of Experimental Medicine. 1969;99(3):269-80.
Goa KL, Brogden RN. l-Carnitine: A preliminary review of its pharmacokinetics, and its therapeutic use in ischaemic cardiac disease and primary and secondary carnitine deficiencies in relationship to its role in fatty acid metabolism. Drugs. 1987;34:1-24.
Prasad AS. Zinc in growth and development and spectrum of human zinc deficiency. Journal of the American College of Nutrition. 1988;7(5): 377-84.
Ursini F, Heim S, Kiess M, Maiorino M, Roveri A, Wissing J, Flohé L. Dual function of the selenoprotein PHGPx during sperm maturation. Science. 1999;285(5432): 1393-6.
Hansen JC, Deguchi Y. Selenium and fertility in animals and man–A review. Acta Veterinaria Scandinavica. 1996;37: 19-30.
Wong WY, Merkus HM, Thomas CM, Menkveld R, Zielhuis GA, Steegers-Theunissen RP. Effects of folic acid and zinc sulfate on male factor subfertility: a double-blind, randomized, placebo-controlled trial. Fertility and sterility. 2002; 77(3):491-8.
Agarwal A, Prabakaran S, Allamaneni S. What an andrologist/urologist should know about free radicals and why. Urology. 2006;67(1):2-8.
Colagar AH, Marzony ET. Ascorbic Acid in human seminal plasma: Determination and its relationship to sperm quality. Journal of clinical biochemistry and nutrition. 2009; 45(2):144-9.
Brigelius‐Flohé R, Traber MG. Vitamin E: function and metabolism. The FASEB Journal. 1999;13(10):1145-55.
Ross C, Morriss A, Khairy M, Khalaf Y, Braude P, Coomarasamy A, El-Toukhy T. A systematic review of the effect of oral antioxidants on male infertility. Reproductive biomedicine online. 2010 Jun 1;20(6):711-23.
Johansen L, Bøhmer T. Carnitine-binding related supressed oxygen uptake by spermatozoa. Archives of Andrology. 1978;1(4):321-4.
Radigue C, Es-Slami S, Soufir JC. Relationship of carnitine transport across the epididymis to blood carnitine and androgens in rats. Archives of Andrology. 1996;37(1):27-31.
Balercia G, Buldreghini E, Vignini A, Tiano L, Paggi F, Amoroso S, Ricciardo-Lamonica G, Boscaro M, Lenzi A, Littarru G. Coenzyme Q10 treatment in infertile men with idiopathic asthenozoospermia: a placebo-controlled, double-blind randomized trial. Fertility and sterility. 2009;91(5):1785-92.
Hadwan MH, Almashhedy LA, Alsalman AR. Oral zinc supplementation restore high molecular weight seminal zinc binding protein to normal value in Iraqi infertile men. BMC urology. 2012 Dec;12(1):1-6.
Elgazar V, Razanov V, Stoltenberg M, Hershfinkel M, Huleihel M, Nitzan YB, Lunenfeld E, Sekler I, Silverman WF. Zinc-regulating proteins, ZnT-1, and metallothionein I/II are present in different cell populations in the mouse testis. Journal of Histochemistry & Cytochemistry. 2005;53(7):905-12.
Imhof M, Lackner J, Lipovac M, Chedraui P, Riedl C. Improvement of sperm quality after micronutrient supplementation. e-SPEN Journal. 2012;7(1):e50-3.
Lenzi A, Sgro P, Salacone P, Paoli D, Gilio B, Lombardo F, Santulli M, Agarwal A, Gandini L. A placebo-controlled double-blind randomized trial of the use of combined l-carnitine and l-acetyl-carnitine treatment in men with asthenozoospermia. Fertility and sterility. 2004;81(6):1578-84.
Safarinejad MR, Safarinejad S. Efficacy of selenium and/or N-acetyl-cysteine for improving semen parameters in infertile men: A double-blind, placebo controlled, randomized study. The Journal of urology. 2009;181(2):741-51.
Vander Borght M, Wyns C. Fertility and infertility: Definition and epidemiology. Clinical Biochemistry. 2018;62:2-10.
Horváth M, Czeizel E. Effect of new dietary supplement on sperm quality. Orvosi Hetilap. 2012 Nov 1;153(45):1787-92.
Lombardo F, Sansone A, Romanelli F, Paoli D, Gandini L, Lenzi A. The role of antioxidant therapy in the treatment of male infertility: an overview. Asian Journal of Andrology. 2011;13(5): 690.
Paradiso Galatioto G, Gravina GL, Angelozzi G, Sacchetti A, Innominato PF, Pace G, Ranieri G, Vicentini C. May antioxidant therapy improve sperm parameters of men with persistent oligospermia after retrograde embolization for varicocele?. World Journal of Urology. 2008;26:97-102.
Tayade H P, Rathod O K, Evaluation of efficacy of multiple micronutrients supplements alone or in combination with concomitant therapy in subfertile male. Journal of Pharmaceutical Research and Clinical Practice; 2012
Micic S, Lalic N, Nale DJ, Bojanic N. Effects of L-carnitine on sperm motility and number in infertile men. Fertility and Sterility-International Edition-. 1998;70:O-030.
Kessopoulou E, Powers HJ, Sharma KK, Pearson MJ, Russell JM, Cooke ID, Barratt CL. A double-blind randomized placebo cross-over controlled trial using the antioxidant vitamin E to treat reactive oxygen species associated male infertility. Fertility and sterility. 1995;64(4):825-31.
Vézina D, Mauffette F, Roberts KD, Bleau G. Selenium-vitamin E supplementation in infertile men: effects on semen parameters and micronutrient levels and distribution. Biological Trace Element Research. 1996;53:65-83.
Tremellen K, Miari G, Froiland D, Thompson J. A randomised control trial examining the effect of an antioxidant (Menevit) on pregnancy outcome during IVF‐ICSI treatment. Australian and New Zealand Journal of Obstetrics and Gynaecology. 2007;47(3):216-21.
Matalliotakis I, Koumantaki Y, Evageliou A, Matalliotakis G, Goumenou A, Koumantakis E. L-carnitine levels in the seminal plasma of fertile and infertile men: Correlation with sperm quality. International journal of fertility and women's medicine. 2000;45(3):236-40.
Henkel R, Sandhu IS, Agarwal A. The excessive use of antioxidant therapy: A possible cause of male infertility?. Andrologia. 2019;51(1):e13162.