Jennifer F Knudtson1, Fangbai Sun2, R Matthew Coward3, Karl R Hansen4, Kurt T Barnhart5, James Smith6, Richard S Legro7, Michael P Diamond8, Stephen A Krawetz9, Heping Zhang2, Rebecca Usadi10, Valerie L Baker11, Nanette Santoro12, Anne Z Steiner13. 1. Department of Obstetrics and Gynecology, University of Texas Health Science Center San Antonio, San Antonio, Texas; and Aspire Fertility, San Antonio, TX, USA. jenk1022@gmail.com. 2. Department of Biostatistics, Yale School of Public Health, New Haven, CT, USA. 3. Department of Urology, University of North Carolina, Chapel Hill, NC, USA. 4. Department of Obstetrics and Gynecology, Health Sciences Center, University of Oklahoma, Oklahoma City, OK, USA. 5. Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, PA, USA. 6. Department of Urology, University of California- San Francisco, San Francisco, CA, USA. 7. Department of Obstetrics and Gynecology, Pennsylvania State University, Hershey, PA, USA. 8. Department of Obstetrics and Gynecology, Medical College of Georgia, Augusta University, Augusta, GA, USA. 9. Department of Obstetrics and Gynecology & Molecular Medicine and Genetics, Wayne State University, Detroit, MI, USA. 10. Department of Reproductive Endocrinology and Infertility, Atrium Health, Charlotte, NC, USA. 11. Department of Gynecology and Obstetrics, Division of Reproductive Endocrinology and Infertility, Johns Hopkins University, Lutherville, MD, USA. 12. Department of Obstetrics and Gynecology, University of Colorado School of Medicine, Aurora, CO, USA. 13. Department of Reproductive Endocrinology and Infertility, Duke University School of Medicine, Durham, NC, USA.
Abstract
PURPOSE: The understanding of the role of plasma antioxidant levels in male fertility in the USA is limited. In a secondary analysis of the Males, Antioxidants, and Infertility (MOXI) randomized clinical trial, we sought to determine whether serum levels of vitamin E (α-tocopherol), zinc, and selenium were correlated with semen parameters and couple fertility outcomes. METHODS: This study is a secondary analysis of the MOXI clinical trial. The primary endpoints in this secondary analysis include semen parameters, and DNA fragmentation and clinical outcomes including pregnancy and live birth. Analyses were completed using Wilcoxon's rank-sum test and linear regression models. RESULTS: At baseline, the analysis included plasma labs for vitamin E (n = 131), selenium (n = 124), and zinc (n = 128). All baseline plasma values were in the normal ranges. There was no association between selenium, zinc, or vitamin E levels and semen parameters or DNA fragmentation. Baseline antioxidant levels in the male partners did not predict pregnancy or live birth among all couples. Among those randomized to placebo, baseline male antioxidant levels did not differ between those couples with live birth and those that did not conceive or have a live birth. CONCLUSIONS: Among men attending fertility centers in the USA, who have sufficient plasma antioxidant levels of zinc, selenium, or vitamin E, no association was observed between vitamins and semen parameters or clinical outcomes in couples with male infertility. Higher levels of antioxidants among men with circulating antioxidants in the normal range do not appear to confer benefit on semen parameters or male fertility.
PURPOSE: The understanding of the role of plasma antioxidant levels in male fertility in the USA is limited. In a secondary analysis of the Males, Antioxidants, and Infertility (MOXI) randomized clinical trial, we sought to determine whether serum levels of vitamin E (α-tocopherol), zinc, and selenium were correlated with semen parameters and couple fertility outcomes. METHODS: This study is a secondary analysis of the MOXI clinical trial. The primary endpoints in this secondary analysis include semen parameters, and DNA fragmentation and clinical outcomes including pregnancy and live birth. Analyses were completed using Wilcoxon's rank-sum test and linear regression models. RESULTS: At baseline, the analysis included plasma labs for vitamin E (n = 131), selenium (n = 124), and zinc (n = 128). All baseline plasma values were in the normal ranges. There was no association between selenium, zinc, or vitamin E levels and semen parameters or DNA fragmentation. Baseline antioxidant levels in the male partners did not predict pregnancy or live birth among all couples. Among those randomized to placebo, baseline male antioxidant levels did not differ between those couples with live birth and those that did not conceive or have a live birth. CONCLUSIONS: Among men attending fertility centers in the USA, who have sufficient plasma antioxidant levels of zinc, selenium, or vitamin E, no association was observed between vitamins and semen parameters or clinical outcomes in couples with male infertility. Higher levels of antioxidants among men with circulating antioxidants in the normal range do not appear to confer benefit on semen parameters or male fertility.
Authors: Elsje C Oostingh; Régine P M Steegers-Theunissen; Jeanne H M de Vries; Joop S E Laven; Maria P H Koster Journal: Fertil Steril Date: 2017-03-11 Impact factor: 7.329