Андрология и генитальная хирургия. 2024; 25: 121-128
Оценка эффективности и безопасности применения антиоксидантного комплекса «Спермаферт»
https://doi.org/10.62968/2070-9781-2024-25-3-121-128Аннотация
Активные формы кислорода негативно влияют на показатели эякулята и сперматогенез в целом. В этом исследовании оценивалась эффективность и безопасность комбинированной антиоксидантной терапии в отношении лечения мужского бесплодия. Производилась оценка общих показателей эякулята и индекс фрагментации ДНК сперматозоидов. Мужчинам с высоким индексом фрагментации ДНК сперматозоидов было рекомендовано принимать по 1 капсуле и 5 мл жидкости (1 мерная ложка) 1 раз в день во время еды. В составе жидкости L-карнитин – 900 мг; В составе 1 капсулы: липоевая кислота – 96 мг, витамин С – 72 мг, цитрат цинка – 56 мг, витамин В6 – 2,4 мг, фолиевая кислота – 0,48 мг, 9-фенил-симметричный октагидроселеноксантен – 0,34 мг. До и после лечения оценивались общие показатели эякулята и индекс фрагментации ДНК сперматозоидов.
Полученные результаты. После трех месяцев лечения антиоксидантным комплексом «Спермаферт» показатели эякулята улучшились, о чем свидетельствует снижение индекса фрагментации ДНК сперматозоидов с 21,6 ± 3,2% до 12,8 ± 3,3%; увеличение концентрации сперматозоидов с 29,7 × 106 /мл до 35,7 × 106 /мл (p < 0,001), увеличение общего количества сперматозоидов с 72,1 × 106 до 95,5 × 106 (p = 0,012).
Выводы. Прием антиоксидантов может улучшить общие показатели эякулята и снизить уровень индекса фрагментации ДНК сперматозоидов у мужчин в бесплодном браке. Выводы данного исследования совпадают с общими трендами в данном направлении.
Список литературы
1. Sharlip I.D. et al. Best practice policies for male infertility. // Fertil Steril. 2002. Vol. 77, № 5. P. 873–882.
2. Naz, M., Kamal, M. Classification, causes, diagnosis and treatment of male infertility: a review. Orient Pharm Exp Med 17, 89–109 (2017). https://DOI.org/10.1007/s13596-017-0269-7.
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13. Stenqvist A. et al. Impact of antioxidant treatment on DNA fragmentation index: a double-blind placebo-controlled randomized trial. // Andrology. 2018. Vol. 6, № 6. P. 811–816.
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18. Fernández J.L. et al. Halosperm is an easy, available, and cost-effective alternative for determining sperm DNA fragmentation. // Fertil Steril. 2005. Vol. 84, № 4. P. 860.
19. Agarwal A. et al. Male Oxidative Stress Infertility (MOSI): Proposed Terminology and Clinical Practice Guidelines for Management of Idiopathic Male Infertility. // World J Mens Health. 2019. Vol. 37, № 3. P. 296–312.
20. Moslemi M.K., Tavanbakhsh S. Selenium-vitamin E supplementation in infertile men: effects on semen parameters and pregnancy rate. // Int J Gen Med. 2011. Vol. 4. P. 99–104.
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24. Rolf C. et al. Antioxidant treatment of patients with asthenozoospermia or moderate oligoasthenozoospermia with high-dose vitamin C and vitamin E: a randomized, placebocontrolled, double-blind study. // Hum Reprod. 1999. Vol. 14, № 4. P. 1028–1033.
25. Sigman M. et al. Carnitine for the treatment of idiopathic asthenospermia: a randomized, double-blind, placebo-controlled trial. // Fertil Steril. 2006. Vol. 85, № 5. P. 1409–1414.
26. Steiner A.Z. et al. The effect of antioxidants on male factor infertility: the Males, Antioxidants, and Infertility (MOXI) randomized clinical trial. // Fertil Steril. 2020. Vol. 113, № 3. P. 552–560.e3.
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Andrology and Genital Surgery. 2024; 25: 121-128
Evaluation of the effectiveness and safety of the use of the antioxidant complex “Spermafert”
https://doi.org/10.62968/2070-9781-2024-25-3-121-128Abstract
Reactive oxygen species negatively affect the indicators of ejaculate and spermatogenesis in general. This study evaluated the efficacy and safety of combination antioxidant therapy with respect to the treatment of male infertility. The general indicators of the ejaculate and the sperm DNA fragmentation index were assessed. Men with a high sperm DNA fragmentation index were recommended to take 1 capsule and 5 ml of liquid (1 scoop) once a day with meals. The liquid contains L-carnitine – 900 mg; 1 capsule contains: lipoic acid - 96 mg, vitamin C – 72 mg, zinc citrate – 56 mg, vitamin B6 – 2.4 mg, folic acid – 0.48 mg, 9-phenyl-symmetric octahydroselenoxanthene – 0.34 mg.
Results. After three months of treatment with the antioxidant complex "Spermafert", ejaculate values improved, as evidenced by a decrease in the sperm DNA fragmentation index from 21.6 ± 3.2% to 12.8 ± 3.3%; an increase in sperm concentration from 29.7× 106 /ml to 35.7 × 106 /ml an increase in the total sperm count from 72.1 × 106 to 95.5 × 106.
Findings. Taking antioxidants can improve overall ejaculate counts and lower sperm DNA fragmentation index levels in men in infertile marriages. The conclusions of this study coincide with general trends in this direction.
References
1. Sharlip I.D. et al. Best practice policies for male infertility. // Fertil Steril. 2002. Vol. 77, № 5. P. 873–882.
2. Naz, M., Kamal, M. Classification, causes, diagnosis and treatment of male infertility: a review. Orient Pharm Exp Med 17, 89–109 (2017). https://DOI.org/10.1007/s13596-017-0269-7.
3. Ozmen B. et al. DNA damage of human spermatozoa in assisted reproduction: origins, diagnosis, impacts and safety. // Reprod Biomed Online. 2007. Vol. 14, № 3. P. 384–395.
4. Obshchaya andrologiya. Klinicheskie rekomendatsii / Pod redaktsiei P. A. Shchepleva; nauchnyi redaktor N. P. Naumov. — M.: ProfMedPress; SPb.: Skifiya-print, 2022. — 440 s. ISBN 978-5-98620-582-3.
5. Borini A. et al. Sperm DNA fragmentation: paternal effect on early post-implantation embryo development in ART // Human Reproduction. 2006. Vol. 21, № 11. P. 2876–2881.
6. Al-Gubory K.H., Fowler P.A., Garrel C. The roles of cellular reactive oxygen species, oxidative stress and antioxidants in pregnancy outcomes. // Int J Biochem Cell Biol. 2010. Vol. 42, № 10. P. 1634–1650.
7. FORD C.E. et al. The chromosomes in a patient showing both mongolism and the Klinefelter syndrome. // Lancet. 1959. Vol. 1, № 7075. P. 709–710.
8. Makker K., Agarwal A., Sharma R. Oxidative stress & male infertility. // Indian J Med Res. 2009. Vol. 129, № 4. P. 357–367.
9. Henkel R., Offor U., Fisher D. The role of infections and leukocytes in male infertility. // Andrologia. 2021. Vol. 53, № 1. P. e13743.
10. Agarwal A. et al. Clinical utility of sperm DNA fragmentation testing: practice recommendations based on clinical scenarios. // Transl Androl Urol. 2016. Vol. 5, № 6. P. 935–950.
11. Sies H. Strategies of antioxidant defense. // Eur J Biochem. 1993. Vol. 215, № 2. P. 213–219.
12. Smits R.M. et al. Antioxidants for male subfertility. // Cochrane Database Syst Rev. 2019. Vol. 3, № 3. P. CD007411.
13. Stenqvist A. et al. Impact of antioxidant treatment on DNA fragmentation index: a double-blind placebo-controlled randomized trial. // Andrology. 2018. Vol. 6, № 6. P. 811–816.
14. Tunc O., Thompson J., Tremellen K. Improvement in sperm DNA quality using an oral antioxidant therapy. // Reprod Biomed Online. 2009. Vol. 18, № 6. P. 761–768.
15. Brewer L., Corzett M., Balhorn R. Condensation of DNA by spermatid basic nuclear proteins. // J Biol Chem. 2002. Vol. 277, № 41. P. 38895–38900.
16. Agarwal A, Durairajanayagam D, Virk G. Strategies to ameliorate oxidative stress during assisted reproduction. Springer International Publishing Cham. 2014. http://www.springer.com/series/11053.
17. World Health Organization . International Classification of Diseases, 11th Revision (ICD-11) Geneva: WHO; 2018.
18. Fernández J.L. et al. Halosperm is an easy, available, and cost-effective alternative for determining sperm DNA fragmentation. // Fertil Steril. 2005. Vol. 84, № 4. P. 860.
19. Agarwal A. et al. Male Oxidative Stress Infertility (MOSI): Proposed Terminology and Clinical Practice Guidelines for Management of Idiopathic Male Infertility. // World J Mens Health. 2019. Vol. 37, № 3. P. 296–312.
20. Moslemi M.K., Tavanbakhsh S. Selenium-vitamin E supplementation in infertile men: effects on semen parameters and pregnancy rate. // Int J Gen Med. 2011. Vol. 4. P. 99–104.
21. Comhaire F.H. et al. The effects of combined conventional treatment, oral antioxidants and essential fatty acids on sperm biology in subfertile men. // Prostaglandins Leukot Essent Fatty Acids. 2000. Vol. 63, № 3. P. 159–165.
22. Cavallini G. et al. Cinnoxicam and L-carnitine/acetyl-Lcarnitine treatment for idiopathic and varicocele-associated oligoasthenospermia. // J Androl. 2004. Vol. 25, № 5. P. 761–770; discussion 771–2.
23. Wong W.Y. et al. Effects of folic acid and zinc sulfate on male factor subfertility: a double-blind, randomized, placebocontrolled trial. // Fertil Steril. 2002. Vol. 77, № 3. P. 491–498.
24. Rolf C. et al. Antioxidant treatment of patients with asthenozoospermia or moderate oligoasthenozoospermia with high-dose vitamin C and vitamin E: a randomized, placebocontrolled, double-blind study. // Hum Reprod. 1999. Vol. 14, № 4. P. 1028–1033.
25. Sigman M. et al. Carnitine for the treatment of idiopathic asthenospermia: a randomized, double-blind, placebo-controlled trial. // Fertil Steril. 2006. Vol. 85, № 5. P. 1409–1414.
26. Steiner A.Z. et al. The effect of antioxidants on male factor infertility: the Males, Antioxidants, and Infertility (MOXI) randomized clinical trial. // Fertil Steril. 2020. Vol. 113, № 3. P. 552–560.e3.
27. Singh F. et al. Reductive stress impairs myoblasts mitochondrial function and triggers mitochondrial hormesis. // Biochim Biophys Acta. 2015. Vol. 1853, № 7. P. 1574–1585.
