Vitamin E
|
Double blind, placebo cross-over, RCT |
Healthy men with high seminal ROS levels (n = 30) |
600 mg vitamin E x 3 months (n = 15) |
Placebo (n = 15) |
Improved in vitro sperm function (improved zona-binding assay) |
Kessopoulou et al. [101] |
Vitamin E
|
Double blind, placebo-controlled |
Men with (n = 110) asthenozoospermia or oligoasthenozoospermia |
300 mg vitamin E x 6 months (n = 52) |
Placebo (n = 55) |
1. Reduced MDA concentration (less LPO in spermatozoa) |
Suleiman et al. [102] |
2. Improved sperm motility |
3. 20% of those on therapy achieved pregnancy |
Vitamin E + Anti-Estrogen (Clomiphene citrate)
|
Prospective, placebo-controlled RCT |
Infertile men with idiopathic oligozoospermia (n = 60) |
400 mg vitamin E +25 mg clomiphene citrate x 6 months (n = 30) |
Placebo (n = 30) |
1. Improved sperm count and progressive motility |
Ghanem et al. [103] |
2. Partners had higher incidence of pregnancy |
Vitamin E + selenium
|
Open, randomized |
Volunteers and infertile men (n = 54) |
400 mg vitamin E +225 μg selenium x 3 months (n = 28) |
4.5 g vitamin B x 3 months (n = 26) |
1. Reduced MDA concentration (less LPO in spermatozoa) |
Keskes-Ammar et al. [104] |
2. Improved sperm motility |
Vitamin E + selenium
|
Observational study |
Infertile men with idiopathic asthenozoospermia (n = 690) |
400 IU vitamin E +200 μg selenium x 100 days |
None |
1. Improvement in sperm motility/morphology or both (53%) |
Moslemi & Tavanbakhsh [105] |
2. Increased spontaneous pregnancy rates (11%) |
Vitamin E + Vitamin C
|
Double blind, placebo-controlled, RCT |
Men (n = 31) with asthenozoospermia or moderate oligoasthenozoospermia |
1000 mg vitamin C +800 mg vitamin E x 8 weeks (n = 15) |
Placebo (n = 16) |
No improvement in sperm parameters |
Rolf et al. [106] |
No improvement in 24 h sperm survival rate |
Vitamin E + Vitamin C
|
Observational study, double-blind |
Men with elevated sperm DNA fragmentation (≥15%) who have unexplained infertility |
1000 mg vitamin C +1000 mg vitamin E x 2 months (n = 32) |
Placebo (n = 32) |
Reduced percentage of DNA-fragmented sperm (TUNEL test) |
Greco et al. [107] |
Vitamin E + Vitamin C
|
Observational study involving assisted conception treatment |
Men with elevated sperm DNA fragmentation (≥15%) who failed their 1st ICSI attempt |
1000 mg vitamin C +1000 mg vitamin E x 2 months (n = 38) |
None |
1. Reduced percentage of DNA-fragmented sperm (TUNEL test) |
Greco et al. [108] |
2. Marked improvement in implantation and clinical pregnancy rates in the 2nd ICSI attempt vs 1st attempt |
Vitamin C
|
|
Men with sperm agglutination (>25%) (n = 30) |
200 mg vitamin C or 1000 mg vitamin C |
Placebo |
Improved sperm motility, viability, morphology after 4 weeks (more prominent improvement in 1000 mg vitamin C vs. 200 mg vitamin C) |
Dawson et al. [109] |
Vitamin C
|
|
Men who are heavy smokers (n = 75) with normal reproductive function |
200 mg vitamin C or 1000 mg vitamin C |
Placebo |
1. Improved sperm agglutination |
Dawson et al. [110] |
2. Improved 24 h viability |
3. Improved sperm morphology |
Folic acid + zinc sulphate
|
Double blind, placebo-controlled, RCT |
Fertile (n = 108) and subfertile men (n = 103) |
5 mg folic acid, 66 mg zinc sulphate or 5 mg folic acid +66 mg zinc sulphate x 26 weeks |
Placebo or placebo + placebo |
Increased sperm concentration in subfertile and fertile males after combined treatment |
Wong et al. [111] |
Folic acid + zinc sulphate
|
Double blind, placebo-controlled |
Fertile (n = 47) and subfertile men (n = 40) |
5 mg folic acid +66 mg zinc sulphate x 26 weeks |
Placebo |
Increased sperm concentration in infertile males, but not fertile males |
Ebisch et al. [112] |
Folic acid + zinc sulphate
|
Double blind, placebo controlled, RCT |
Subfertile men with OAT (n = 83) |
5 mg folic acid +220 mg zinc sulphate x16 weeks |
Placebo |
Zinc sulfate + folic acid did not improve sperm quality in men with OAT (severely compromised sperm parameters) |
Raigani et al. [113] |
Folic acid + zinc sulphate
|
Prospective, randomized controlled |
Men with palpable varicocele (grade III) who underwent surgical repair of varicocele (n = 160) |
5 mg folic acid (n = 26), 66 mg zinc sulphate (n = 32) or 5 mg folic acid +66 mg zinc sulphate (n = 29) x 6 months |
Placebo (n = 25) |
1. Zinc sulfate + folic acid improved sperm parameters and improved varicocelectomy outcomes |
Azizollahi et al. [114] |
2. Improved protamine content and halo formation rate |
Coenzyme Q
10
|
Systematic review and meta-analysis (3 RCTs) |
Infertile men |
CoQ10 (n = 149) |
Controls (n = 147) |
1. Improved seminal CoQ10 levels |
Lafuente et al. [115] |
2. Increased sperm concentration |
3. Increased sperm motility |
4. No increase in pregnancy rates |
5. Data on live births were lacking |
Coenzyme Q
10
|
Double blind, placebo-controlled, RCT |
Men with iOT (n = 60) |
200 mg CoQ10 x 3 months (n = 30) |
Placebo (Lactose) (n = 30) |
1. Increased levels of CoQ10 in seminal plasma |
Nadjarzadeh et al. [116] |
2. Decreased 8-isoprostane levels (biomarker of LPO) (attenuation of OS in seminal plasma) |
3. Increased sperm forward and total motility |
4. Increased catalase, SOD activity |
Coenzyme Q
10
|
Double blind, placebo-controlled, RCT |
Men with iOAT (n = 47) |
200 mg CoQ10 x 12 weeks |
Placebo |
1. Reduced TBARS (reduced plasma MDA levels) |
Nadjarzadeh et al. [117] |
2. Increased TAC in seminal plasma |
Coenzyme Q
10
|
Double blind, placebo-controlled, RCT |
Men with iOAT (n = 228) |
200 mg ubiquinol x 26 weeks (n = 114) |
Placebo (n = 114) |
Improved sperm quality (density, motility, normal strict morphology) |
Safarinejad et al. [118] |
Coenzyme Q
10
|
Double blind, placebo-controlled, RCT |
Men with idiopathic infertility (n = 60) |
200 mg CoQ10 x 6 months |
Placebo |
1. Increase in CoQ10 and ubiquinol in seminal plasma and spermatozoa |
Balercia et al. [119] |
2. Increase in spermatozoa motility |
Coenzyme Q
10
|
Prospective |
Men with iOAT (n = 212) |
300 mg CoQ10 x 26 weeks (n = 106) |
Placebo (n = 106) |
1. Improved sperm density, motility, normal strict morphology |
Safarinejad [120] |
2. Improved acrosome reaction |
Coenzyme Q
10
|
Open-label, prospective |
Men with iOAT (n = 287) |
600 mg CoQ10 x 12 months (n = 106) |
None |
1. Improved sperm quality (concentration, progressive motility, normal morphology) |
Safarinejad [121] |
2. Improved pregnancy rates |