Personified correction of micronutrient deficiency as a therapeutic tactic for improving the quality of ejaculate in idiopathic infertility

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Abstract

Introduction. Marital infertility is one of the key medical problems. Almost 50% of infertility in marriage is caused by male infertility. The proportion of idiopathic male infertility is 30–40%.

Material and methods. 157 patients with idiopathic infertility were randomized into 2 groups. The main group (MG) (n = 82): conducted a correction of the level of micronutrients in case of their deficiency by the appointment of monocomponent drugs in the maximum permitted daily doses. The control group (n = 75) (empirical therapy with complex drugs) was randomized to subgroup 1 (CG1) (n = 38): complex preparations with L-carnitine were used; and subgroup 2 (CG2) (n = 37): complex multivitamin preparations without L-carnitine were used. To identify micronutrient deficiencies, 93 healthy volunteers who realized a fertile function were examined (their partners were in the third trimester of pregnancy).

Results. Deficiencies of micronutrients were determined: selenium, zinc, vitamins C and E. Correction was carried out for three months with monocomponent preparations. In the exhaust gas, there was a positive dynamics in all parameters of the spermogram. In the control subgroups the ejaculate volume, concentration, total sperm count did not change, an increase in the general and progressive motility was revealed. The proportion of normal spermatozoa increased in MG, CG1 and CG2 groups by 61.9%, 28.6% (in comparison with MG p < 0.01) and 20.0% (in comparison with MG p < 0.001), respectively. Total mobility increased – by 44.5%, 24.5% (compared to MG p < 0.05), by 12.0% (compared to exhaust gas p < 0.001), respectively. Progressive mobility – by 60.4%, 54.5% (compared with MG p > 0.05), 14.7% (compared with MG p < 0.001), respectively. Pregnancy in MG was 21.9%, in CG1 – 5.2% (p < 0.05) and CG2 – 2.7% (p < 0.05).

Conclusion. Personified correction of micronutrient deficiency in order to improve the quality of ejaculate in idiopathic male infertility was an effective therapeutic tactic. The results obtained suggest that this approach is more pathogenetically justified, which requires further study.

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About the authors

Anton Yu. Tsukanov

Omsk State Medical University of the Ministry of Healthcare of the Russian Federation

Author for correspondence.
Email: autt@mail.ru
ORCID iD: 0000-0002-3497-5856
SPIN-code: 9310-1220
Scopus Author ID: 57194497218

Doctor of Medical Science, Professor, Head of the Department of Surgical Diseases and Urology of Postgraduate Education

Russian Federation, Omsk

Danijar A. Satibaldin

Omsk State Medical University of the Ministry of Healthcare of the Russian Federation

Email: danijar87@mail.ru
ORCID iD: 0000-0002-3978-1778

Assistant of the Department of Surgical Diseases and Urology of Postgraduate Education

Russian Federation, Omsk

References

  1. Корнеев И.А., Зассеев Р.Д., Шевчук И.Г., Пелипейченко А.А. Распространенность инфекций, передающихся половым путем, у мужчин, состоящих в бесплодном браке // Урологические ведомости. – 2018. – Т. 8. – № 2. – С. 30–35. [Korneyev IA, Zasseev RD, Shevchuk IG, Pelipejchenko AA. Prevalence of sexually transmitted diseases among men from infertile couples. Urologicheskie vedomosti. 2018;8(2):30-35. (In Russ.)]. https://doi.org/10.17816/uroved8230-35.
  2. Корнеев И.А., Зассеев Р.Д., Исакова Э.В., и др. Оказание медицинской помощи с применением вспомогательных репродуктивных технологий у мужчин: обзор клинических рекомендаций и алгоритм маршрутизации пациентов // Проблемы репродукции. 2018;24(4):59–65. [Korneyev IA, Zaseev RD, Isakova EV, et al. Assisted reproductive techniques in men: review of clinical guidelines and workup algorithm. Modern reproductive technologies. 2018;24(4):59-65. (In Russ.)]. https://doi.org/10.17116/repro20182404159.
  3. Урология. Российские клинические рекомендации / под ред. Ю.Г. Аляева, П.В. Глыбочко, Д.Ю. Пушкаря. – М.: Медфорум. 2017. – 544с. [Urologiya. Rossiyskie klinicheskie rekomendatsii. Ed. by Y.G. Alyaev, P.V. Glybochko, D.Y. Pushkar’. Moscow: Medforum; 2017. 544 p. (In Russ.)]
  4. Salonia A, Bettocchi C, Carvalho J, et al. Sexual and Reproductive Health. Guideline of European Association of Urology. Guidelines. 2020.
  5. Zegers-Hochschild F, Adamson GD, de Mouzon J, et al. International Committee for Monitoring Assisted Reproductive Technology (ICMART) and the World Health Organization (WHO) revised glossary of ART terminology, 2009. Fertil Steril. 2009;92(5):1520-1524. https://doi.org/10.1016/j.fertnstert.2009.09.009.
  6. Arafa M, Agarwal A, Majzoub A, et al. Efficacy of Antioxidant Supplementation on Conventional and Advanced Sperm Function Tests in Patients with Idiopathic Male Infertility. Antioxidants (Basel). 2020;9(3). https://doi.org/10.3390/antiox9030219.
  7. Smits RM, Mackenzie-Proctor R, Yazdani A, et al. Antioxidants for male subfertility. Cochrane Database Syst Rev. 2019;3: CD007411. https://doi.org/10.1002/14651858.CD007411.pub4.
  8. Bui AD, Sharma R, Henkel R, Agarwal A. Reactive oxygen species impact on sperm DNA and its role in male infertility. Andrologia. 2018;50(8): e13012. https://doi.org/10.1111/and.13012.
  9. Wagner H, Cheng JW, Ko EY. Role of reactive oxygen species in male infertility: An updated review of literature. Arab J Urol. 2018;16(1):35-43. https://doi.org/10.1016/j.aju.2017.11.001.
  10. Aitken RJ, Koppers AJ. Apoptosis and DNA damage in human spermatozoa. Asian J Androl. 2011;13(1):36-42. https://doi.org/10.1038/aja.2010.68.
  11. Agarwal A, Virk G, Ong C, du Plessis SS. Effect of oxidative stress on male reproduction. World J Mens Health. 2014;32(1):1-17. https://doi.org/10.5534/wjmh.2014.32.1.1.
  12. Agarwal A, Parekh N, Panner Selvam MK, et al. Male Oxidative Stress Infertility (MOSI): Proposed Terminology and Clinical Practice Guidelines for Management of Idiopathic Male Infertility. World J Mens Health. 2019;37(3):296-312. https://doi.org/10.5534/wjmh.190055.
  13. Наумов Н.П., Щеплев П.А., Полозов В.В. Роль антиоксидантов в профилактике мужского бесплодия // Андрология и генитальнаях хирургия. – 2019. – Т. 20. – № 1. – С. 22–29. [Naumov NP, Scheplev PA, Polozov VV. The role of antioxidants in prevention of male infertility. Andrology and Genital Surgery. 2019;20(1):22-29. (In Russ.)]. https://doi.org/10.17650/2070-9781-2019-20-1-22-29.
  14. Гамидов С.И., Попова А.Ю., Гасанов Н.Г., и др. Оценка влияния комплекса «БЕСТФертил» на показатели спермограммы, оксидативного стресса и фрагментации ДНК сперматозоидов у мужчин с бесплодием // Андрология и генитальная хирургия. – 2019. – Т. 20. – № 1. – С. 91–98. [Gamidov SI, Popova AY, Gasanov NG, et al. Assessment of influence of “BESTFertil” supplement on semen analysis parameters, oxidative stress markers and sperm DNA fragmentation index in infertile males. Andrology and Genital Surgery. 2019;20(1):91-98. (In Russ.)] https://doi.org/10.17650/2070-9781-2019-20-1-91-98.
  15. Wong WY, Thomas CMG, Merkus JMWM, et al. Male factor subfertility: possible causes and the impact of nutritional factors. Fertil Steril. 2000;73(3):435-442. https://doi.org/10.1016/s0015-0282(99)00551-8.
  16. Brody S.A. Мужское бесплодие и окислительный стресс: роль диеты, образа жизни и пищевых добавок // Андрология и генитальная хирургия. – 2014. – Т. 15. – № 3. – С. 33–41. [Brody SA. Male factor infertility and oxidative stress: role of diet, lifestyle and nutritional supplements. Andrology and Genital Surgery. 2014;15(3):33-41. (In Russ.)]. https://doi.org/10.17650/2070-9781-2014-3-33-41.
  17. Salas-Huetos A, Bulló M, Salas-Salvadó J. Dietary patterns, foods and nutrients in male fertility parameters and fecundability: a systematic review of observational studies. Hum Reprod Update. 2017;23(4):371-389. https://doi.org/10.1093/humupd/dmx006.
  18. Турчанинов Д.В., Вильмс Е.А., Боярская Л.А., Турчанинова М.С. Воздействие питания и образа жизни на здоровье населения // Пищевая промышленность. – 2015. – № 1. – С. 8–11. [Turchaninov DV, Wilms EA, Boyarskaya LA, Turchaninova MS. The Impact Diet and Lifestyle on Public Health: Current Approaches to Assessment and Strategies for Prevention. Pishchevaya promyshlennost’. 2015;(1):8-11. (In Russ.)]
  19. Юнацкая Т.А., Цуканов А.Ю., Турчанинов Д.В., и др. Особенности фактического питания и их связь с характеристиками эякулята у мужчин с идиопатическим бесплодием: потенциал алиментарной профилактики и коррекции // Гигиена и санитария. –2019. – Т. 98. – № 7. – С. 788–792. [Yunatskaya TA, Tsukanov AY, Turchaninov DV, et al. Features of actual nutrition and their relationship with characteristics of the semen indices in men with idiopathic infertility: the potential of alimentary prevention and correction. Gig Sanit. 2019;98(7):788-792. (In Russ.)] https://doi.org/10.18821/0016-9900-2019-98-7-788-792.
  20. Губергриц А.Я., Линевский Ю.В. Лечебное питание: Справочное пособие. 3-е изд. – Киев: Высшая школа, 1989. – 398 с. [Gubergrits AY, Linevsky YV. Lechebnoe pitanie: Spravochnoe posobie. 3rd ed. Kiev: Vysshaya shkola; 1989. 398 p. (In Russ.)]
  21. Abad C, Amengual MJ, Gosalvez J, et al. Effects of oral antioxidant treatment upon the dynamics of human sperm DNA fragmentation and subpopulations of sperm with highly degraded DNA. Andrologia. 2013;45(3):211-216. https://doi.org/10.1111/and.12003.
  22. Gharagozloo P, Gutierrez-Adan A, Champroux A, et al. A novel antioxidant formulation designed to treat male infertility associated with oxidative stress: promising preclinical evidence from animal models. Hum Reprod. 2016;31(2):252-262. https://doi.org/10.1093/humrep/dev302.
  23. Comhaire FH, El Garem Y, Mahmoud A, et al. Combined conventional/antioxidant “Astaxanthin” treatment for male infertility: a double blind, randomized trial. Asian J Androl. 2005;7(3):257-262. https://doi.org/10.1111/j.1745-7262.2005.00047.x.
  24. Zini A, Al-Hathal N. Antioxidant therapy in male infertility: fact or fiction? Asian J Androl. 2011;13(3):374-381. https://doi.org/10.1038/aja.2010.182.

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