High sperm DNA fragmentation: do we have robust evidence to support antioxidants and testicular sperm extraction to improve fertility outcomes? a narrative review

Frontiers in Endocrinology

Endocrinology

Federico Cirillo¹  Andrea Busnelli²  Paolo Emanuele Levi-Setti²  Daria Spadaro²  Massimo Romano²  Stefano Castellano²  Elena Albani² 

[1] Department of Gynecology, Division of Gynecology and Reproductive Medicine, Fertility Center, Humanitas Research Hospital, IRCCS, Milan, Italy;Department of Gynecology, Division of Gynecology and Reproductive Medicine, Fertility Center, Humanitas Research Hospital, IRCCS, Milan, Italy;Department of Biomedical Sciences, Humanitas University, Milan, Italy;

关键词: sperm DNA fragmentation;    sperm dna damage;    reactive oxygen species (ROS) levels;    antioxidant;    Testicular sperm retrieval;    sperm DNA in testicular sperm;   

DOI  :  10.3389/fendo.2023.1150951

 received in 2023-01-25, accepted in 2023-09-01,  发布年份 2023

来源: Frontiers

【 摘 要 】

To date, infertility affects 10% to 15% of couples worldwide. A male factor is estimated to account for up to 50% of cases. Oral supplementation with antioxidants could be helpful to improve sperm quality by reducing oxidative damage. At the same time, there is a growing interest in the literature on the use of testicular sperm in patients with high DNA fragmentation index (DFI). This narrative review aims to evaluate the effectiveness of supplementation of oral antioxidants in infertile men with high DFI compared to testicular sperm retrieval. The current evidence is non-conclusive because of serious risk of bias due to small sample sizes and statistical methods. Further large well-designed randomised placebo-controlled trials are still required to clarify the exact role of these to different therapeutic approaches.

【 授权许可】

Unknown   
Copyright © 2023 Romano, Cirillo, Spadaro, Busnelli, Castellano, Albani and Levi-Setti