Micronutrient supplements as antioxidants in improving sperm quality and reducing DNA fragmentation

Background Spermatogenesis and sperm quality may be negatively impacted by an increase in reactive oxygen species. This study investigates the efficacy of combined antioxidant therapy for treating male infertility, as measured by semen analyses and the sperm DNA fragmentation index (DFI). Infertile men with a high sperm DNA fragmentation index were instructed to take two oral micronutrient capsules daily for three months. Each antioxidant formulation contained 60 mg vitamin E, 400 [micro]g folic acid, 30 mg selenium, 125 mg L-arginine, 220 mg L-carnitine, 7.5 mg coenzyme Q10, 40 mg L-glutathione, and 20 mg zinc citrate. At entry and post-treatment, the general characteristics, semen analysis, and sperm chromatin dispersion assays were recorded and compared. Results After three months of treatment with antioxidant compounds, the quality of spermatozoa improved significantly, as indicated by a decrease in the mean DNA fragmentation index from 45.6 [+ or -] 17.2% to 34.8 [+ or -] 20.3%; an increase in sperm concentration from 29.7 x 10.sup.6/mL to 35.7 x 10.sup.6/mL (p < 0.001), an increase in a total number of spermatozoa from 72.1 x 10.sup.6 to 95.5 x 10.sup.6 (p = 0.012), and an increase in the vitality from 75.5 [+ or -] 17.1 to 81.1 [+ or -] 14.4% viable forms (p < 0.001). Conclusions Micronutrient supplementation can improve sperm quality and DNA integrity in infertile men. Men with infertility and significant sperm DNA fragmentation who take antioxidants for three months experience a reduction in DNA fragmentation index and an increase in sperm quality as measured by the semen analysis. Trial registration NCT04509583. Registered 12 August 2020, Hue University of Medicine and Pharmacy Ethics Committee--Retrospectively registered. Keywords: Male infertility, Sperm DNA fragmentation, Antioxidants, Oxidative stress, Reactive oxygen species