The role of alpha lipoic acid in female and male infertility: a systematic review

Abstract

Objective

Infertility is an increasingly frequent health condition, which may depend on female or male factors. Oxidative stress (OS), resulting from a disrupted balance between reactive oxygen species (ROS) and protective antioxidants, affects the reproductive lifespan of men and women. In this review, we examine if alpha lipoic acid (ALA), among the oral supplements currently in use, has an evidence-based beneficial role in the context of female and male infertility.

Methods

We performed a search from English literature using PubMed database with the following keywords: ‘female infertility’, ‘male infertility’, ‘semen’, ‘sperm’, ‘sub-fertile man’, ‘alpha-lipoic acid’, ‘ alpha lipoic acid’, ‘lipoid acid’, ‘endometriosis’, ‘chronic pelvic pain’, ‘follicular fluid’ and ‘oocytes’. We included clinical trials, multicentric studies and reviews. The total number of references found after automatically and manually excluding duplicates was 180. After primary and secondary screening, 28 articles were selected.

Results

The available literature demonstrates the positive effects of ALA in multiple processes from oocyte maturation (0.87 ± 0.9% of oocyte in MII vs 0.81 ± 3.9%; p < .05) to fertilization, embryo development (57.7% vs 75.7% grade 1 embryo; p < .05) and reproductive outcomes. Its regular administration both in sub-fertile women and men shows to reduce pelvic pain in endometriosis (p < .05), regularize menstrual flow and metabolic disorders (p < .01) and improve sperm quality (p < .001).

Conclusions

ALA represents a promising new molecule in the field of couple infertility. More clinical studies are needed in order to enhance its use in clinical practice.

摘要

目的：不孕不育症是一种常见的健康状况, 可能取决于女性或男性因素。氧化应激（OS）是由活性氧（ROS）和保护性抗氧化剂之间平衡破坏引起的, 影响男女的生殖寿命。这篇综述中, 我们研究了在目前应用的α硫辛酸（ALA）口服剂, 是否对女性和男性的不孕不育有益的证据。

方法：我们应用PubMed数据库检索英文文献, 关键词为：女性不育；男性不育；精液；精子；男性亚生育能力；α硫辛酸；α-硫辛酸；硫辛酸；子宫内膜异位症；慢性盆腔疼痛；卵泡液；卵母细胞。我们纳入了临床试验、多中心研究和综述研究文章。自动和手动排除重复项后发现引用总数为180篇, 经过初筛和二次筛选, 共筛选出28篇文章。

结果：现有文献显示ALA在卵母细胞成熟到受精后的多个过程中具有积极作用(在MII中卵母细胞中0.87±0.9% vs 0.81±3.9%;p＜0.05), 在胚胎发育和生殖结果中也有积极作用 (57.7% vs 75.7%;p＜0.05）。对低生育能力的女性和男性定期给予该药可减轻子宫内膜异位症患者的盆腔疼痛(p＜0.05), 可以调节月经血量和代谢紊乱(p ＜0.01)和提高精子质量(p ＜0.001)。

结论：ALA是一种很有前途的新型分子, 可用于夫妻不孕不育领域。为了提高其在临床中的应用, 还需要进行更多的临床研究。

Keywords:

• Alpha lipoic acid
• endometriosis
• infertility
• male factor
• polycystic ovary syndrome

Disclosure statement

No potential conflict of interest was reported by the author(s).

Table 1. Characteristics of the included studies.

Table 2. Alpha lipoic acid (ALA) and male infertility, characteristics of the included studies.