Fertility and Sterility, The Official Journal of the American Society of Reproductive Medicine

Volume 73, Issue 5, Pages 1065-1066 (May 2000)

Antioxidants and male infertility

Jaroslav J. Marik M.D.
Received 1 November 1999;

To the Editor
The recent report of Donnelly et al. (1) is of primarily research and academic interest since the addition of antioxidants directly to sperm before insemination, IVF, or GIFT is at this time not recommended. Nevertheless, it is of interest, even proving that preparation of ascorbate and alpha-tocopherol did not improve sperm motility. The effect of systemic therapy over a sufficiently long time period would be more likely to produce satisfactory results. A beneficial role of antioxidants and lack of these substances in the male is more and more frequently tied to infertility problems, projected by some to be as high as one third. The cause is seen in free radicals, most frequently generated by leukocytes in ejaculate and products of lipoperoxidation (2, 3).

The study would be much more informative if basic systemic and specific levels of antioxidants were measured. Those coming to mind are superoxide dismutase, uric acid, and malondialdehyde. Addition of albumin, gluthathion peroxidase, possibly iron and zinc, would nicely complete the spectrum of substances in question. It is believed that free radicals might damage the DNA of sperm, and antioxidants can ameliorate this negative effect and lower lipoperoxidation. The appropriate level of free radicals in the sperm head is necessary and important in fertilization of oocytes. On the other hand, high antioxidant capacity could interfere with these necessary mechanisms. Superoxide dismutase was found increasing in high presence of superoxides.

Ideally, the basic level of free radicals is determined before treatment of sperm. The treatment could be more likely successful if a wider group of antioxidants is used. The ascorbic acid and tocopherol could form ascorbic radicals with peroxidative effectiveness, thus producing practically opposite results from those expected by antioxidant therapy. One of the components, alpha-tocopherol Trolox, is a water-soluble form of vitamin E and not true physiologic material. It is possible that as such it would not be able to penetrate into the lipids of the sperm itself. A reaction between ascorbates and alpha-tocopherol and other substances present in ejaculate in sperm can produce various other radicals, thus inducing a situation contrary to the one hoped for. In the reported article, such a possibility is demonstrated by the fact that motility of sperm was decreasing with increasing dosage of antioxidants.

The question of a role of antioxidants and free radicals not only in activity of sperm but in many other bodily processes and functions obviously will need further investigation to be answered.

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References

1. Donnelly ET, McClure N, Lewis SEM. Antioxidant supplementation in vitro does not improve human sperm motility. Fertil Steril. 1999;72:484-495 Abstract | Full Text | PDF (275 KB) | MEDLINE | CrossRef
2. Rokyta Z, Racek J, Holecek V, Marik JJ. I. Free radicals and antioxidants in gynecology. Ceska Gynekol. 1998;63:334-339 MEDLINE

3. Rokyta Z, Racek J, Holecek V, Marik JJ. II. Free radicals and antioxidants in obstetrics. Ceska Gynekol. 1998;63:340-345 MEDLINE

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a Tyler Medical Clinic, UCLA School of Medicine, Los Angeles, California, USA
© 2000 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.