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Cited by 79Sperm and Testicular FunctionReproductive Health and TechnologiesMale Reproductive Health Studies

The Effect of Antioxidants on Sperm Quality Parameters and Pregnancy Rates for Idiopathic Male Infertility: A Network Meta-Analysis of Randomized Controlled Trials

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Li, Kun-peng, Yang, Xue-song, Wu, Tao·2022·Frontiers in Endocrinology
DOI 10.3389/fendo.2022.810242PMC PMC8898892
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Abstract

Purpose: Male infertility is a global public health issue recognized by the WHO. Recently, antioxidants are increasingly used to treat idiopathic male infertility. However, the lack of available evidence has led to the inability to rank the effects of antioxidants on the sperm quality parameters and pregnancy rate of infertile men. This network meta-analysis studied the effects of different antioxidants on the sperm quality and pregnancy rate of idiopathic male infertility. Methods: We searched PubMed, Embase, Web of Science, and Cochrane Library databases for randomized controlled trials (RCTs). The weighted mean difference (WMD) and odds ratio (OR) were applied for the comparison of continuous and dichotomous variables, respectively, with 95% CIs. The outcomes were sperm motility, sperm concentration, sperm morphology, and pregnancy rate. Results: A total of 23 RCTs with 1,917 patients and 10 kids of antioxidants were included. l -Carnitine, l -carnitine+ l -acetylcarnitine, coenzyme-Q10, ω-3 fatty acid, and selenium were more efficacious than placebo in sperm quality parameters. l -Carnitine was ranked first in sperm motility and sperm morphology (WMD 6.52% [95% CI: 2.55% to 10.05%], WMD 4.96% [0.20% to 9.73%]). ω-3 fatty acid was ranked first in sperm concentration (WMD 9.89 × 10 6 /ml, [95% CI: 7.01 to 12.77 × 10 6 /ml]). In terms of pregnancy rate, there was no significant effect as compared with placebo. Conclusions: l -Carnitine was ranked first in sperm motility and sperm morphology. ω-3 fatty acid was ranked first in sperm concentration. Coenzyme-Q10 had better effective treatment on sperm motility and concentration. Furthermore, high-quality RCTs with adequate sample sizes should be conducted to compare the outcomes of different antioxidants.

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  • Several studies have evaluated the role of varicocelectomy and antioxidants in improving sperm morphology, particularly for immature sperm and those with head and tail defects based on Kruger's classification.

    “Several studies have evaluated the role of varicocelectomy and antioxidants in improving sperm morphology, particularly for immature sperm and those with head and tail defects based on Kruger’s classification (97-104).”

    From Isolated teratozoospermia: revisiting its relevance in male infertility: a narrative review (2024) · cites this paper as [104]

    The Discussion’s “Sperm Morphology” section reports that antioxidants were evaluated for effects on sperm morphology, with a statistically significant effect for l-carnitine in the network meta-analysis. The Methods’ “Inclusion and Exclusion Criteria” section excludes men with varicocele, so this paper does not evaluate varicocelectomy; the cited passages also do not support the specific claims about immature sperm, head and tail defects, or Kruger’s classification. No page numbers are available in our copy. (LLM, conf=0.90)

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  • A meta-analysis showed that L-carnitine is the best antioxidant to improve sperm morphology among idiopathic male infertility cases.

    “This finding was in line with a meta-analysis that showed that L-carnitine is the best antioxidant to improve sperm morphology among idiopathic male infertility cases (104).”

    From Isolated teratozoospermia: revisiting its relevance in male infertility: a narrative review (2024) · cites this paper as [104]

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Cited by

Sorted by citations

Authors
Li, K.-P., Yang, X.-S., & Wu, T.
Affiliations
Affiliated Hospital of North Sichuan Medical College (CN)
Corresponding author
Wu, Tao
ORCID
Wu, Tao
Venue
Frontiers in Endocrinology
Publisher
Frontiers Media SA
Published
2022-02-21
Volume
13
Pages
810242-810242
ISSN
1664-2392 (ISSN-L)
DOI
10.3389/fendo.2022.810242
PMC
PMC8898892
OpenAlex
W4213264790
Cited by
79
References
4
Citations by year
2026: 19 · 2025: 21 · 2024: 20 · 2023: 15 · 2022: 4
FWCI
2.35
Type
journal article
Language
en
Open access
Licence
Locations
  • Frontiers in Endocrinology (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Topics
  • Health Sciences › Medicine › Reproductive Medicine › Sperm and Testicular Function
  • Health Sciences › Medicine › Reproductive Medicine › Reproductive Health and Technologies
  • Health Sciences › Health Professions › General Health Professions › Male Reproductive Health Studies
Keywords
antioxidants, idiopathic male infertility, semen quality, sperm motility, sperm concentration, sperm morphology, pregnancy rate, L-carnitine, omega-3 fatty acids, coenzyme Q10, selenium, acetyl-L-carnitine
MeSH terms
Antioxidants, Carnitine, Coenzymes, Female, Humans, Infertility, Male, Male, Pregnancy, Spermatozoa, Fatty Acids, Omega-3, Randomized Controlled Trials as Topic, Pregnancy Rate

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