The effect of micronutrient supplementation on spermatozoa DNA integrity in subfertile men and subsequent pregnancy rate

Abstract

Background

Male infertility has been related to an increased sperm DNA fragmentation index (DFI). Nutritional factors may improve sperm nuclear DNA integrity and thus pregnancy rates. Objective: To evaluate the effect of micronutrient supplementation on sperm DNA integrity in subfertile men and subsequent pregnancy rates.

Methods

In this retrospective comparative study 339 subfertile males were included on whom a sperm chromatin dispersion test (SCD) was performed as a method to detect DNA fragmentation, as well as an initial semen analysis. Of all, n = 162 received a nutritional management program for three months, consisting of two daily capsules of a standardized combined micronutrient formulation together with a guidance to diet modification and to lifestyle changes (study group). Each capsule contained L-carnitine, L-arginine, coenzyme Q10, zinc, vitamin E, folic acid, glutathione, and selenium. The control group consisted of those patients who did not receive the active treatment (n = 177), yet were instructed to engage in a healthy lifestyle, including a modification of their regular diet. The SCD test was repeated for both groups after three months. As part of the routine follow up, pregnancy rate was assessed six months after the second SCD test. Males with complete follow up and healthy female partners (aged 18 to 40 years) where included.

Results

Data of men with an initial mean DFI of >15% were analyzed first (n = 81;46 study and 35 control patients). After three months, both groups displayed a significant decrease of mean DFI values; however, the mean percent difference was higher in the study group (10.46 ± 1.20 % vs. 5.29 ± 0.57 %; p < .001). Then, the entire population was considered (n = 339). After three months, only the study group displayed a significant decrease of mean DFI initial values (10.48 ± 7.76 % to 6.51 ± 4.61%; p < .001); and the percent difference was higher in the study group (3.97 ± 0.28 % vs. 0.91 ± 0.28 %; p < .001). At six months follow-up, pregnancy rate was higher in the study group (27.78% vs. 15.25%, p = .002).

Conclusion

Both regimes significantly reduced sperm DNA fragmentation among subfertile men with a DFI >15%; however, when any baseline DFI value was considered, only micronutrient supplementation achieved a better result on DFI and thus pregnancy rate was higher.

补充微量营养素对不育男性精子DNA完整性和后续妊娠率的影响 摘要

背景：男性不育与精子 DNA 碎片指数 (DFI) 增加有关。营养因素可能会提高精子核 DNA 的完整性, 从而提高怀孕率。

目的：评估微量营养素补充剂对不育男性精子 DNA 完整性和后续妊娠率的影响。

方法：在这项回顾性比较研究中, 纳入了 339 名低生育力男性, 对其进行了精子染色质分散试验 (SCD) 作为检测 DNA 断裂的方法, 以及初始精液分析。其中, n = 162 接受了为期三个月的营养管理计划, 包括每日服用两粒标准化复合微量营养素配方胶囊以及饮食调整和生活方式改变的指导（研究组）。每粒胶囊含有左旋肉碱、精氨酸、辅酶 Q10、锌、维生素 E、叶酸、谷胱甘肽和硒。对照组由那些未接受积极治疗的患者（n = 177）组成, 但被建议健康的生活方式, 包括改变他们的常规饮食。三个月后对两组重复 SCD 测试。作为常规随访的一部分, 在第二次 SCD 测试后六个月评估妊娠率。包括完全随访的男性和健康的女性伴侣（18 至 40 岁）。

结果：首先分析初始平均 DFI > 15% 的男性数据（n = 81；46 名研究组患者和 35 名对照组患者）。三个月后, 两组的平均 DFI 值均显著下降；然而, 研究组的平均百分比差异更高（10.46 ± 1.20 % vs. 5.29 ± 0.57 %；p < .001）。然后, 考虑整个样本（n = 339）, 三个月后, 只有研究组的平均 DFI 初始值显着降低（10.48 ± 7.76 % 至 6.51 ± 4.61%；p < .001）；研究组的百分比差异更高（3.97 ± 0.28 % vs. 0.91 ± 0.28 %；p < .001）。在六个月的随访中, 研究组的妊娠率更高（27.78% 对 15.25%, p = .002）。

结论：两种方案都显着减少了 DFI >15% 的低生育力男性的精子 DNA 断裂；然而, 当考虑任何基线 DFI 值时, 只有补充微量营养素才能获得更好的 DFI 结果, 因此妊娠率更高。

Keywords:

• DNA sperm fragmentation
• male infertility
• micronutrients
• supplementation
• pregnancy rate

Correction Statement

This article has been republished with minor changes. These changes do not impact the academic content of the article.

Acknowledgments

The authors thank Lenus Pharma for providing Profertil^® and Halotech DNA SL for providing Halosperm^®.

Author contributions

All authors have made substantial contributions in relation to the research design, statistical analysis, and interpretation and approved the final version of this manuscript.

Disclosure statement

The authors report no conflicts of interest.