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Evidence summaries

Antioxidants for Male Subfertility

Antioxidant supplementation in subfertile males may be effective for improving live birth and pregnancy rate for subfertile couples undergoing assisted reproduction cycles. Level of evidence: "C"

A Cochrane review [Abstract] 1 included 61 studies with a total of 6264 men.

With oral antioxidants (vitamin E, zinc or combined antioxidants) for men, there was a significant increase in live birth rate (table T1). However, outcome events were few (124 live births in 7 small studies).

Antioxidants compared to placebo or no treatment for patients with male subfertility

OutcomeRelative effect (95% CI)Risk with placebo or no treatmentRisk with antioxidants (95% CI)№of participants (studies) Certainty of the evidence
Live birth rate per couple randomisedOR 1.79 (1.20 to 2.67)117 per 1000192 per 1.000 (138 to 262)750 (7) Low
Clinical pregnancy rate per couple randomisedOR 2.97 (1.91 to 4.63)69 per 1000180 per 1.000 (124 to 255)786 (11) Low
Adverse events - MiscarriageOR 1.74 (0.40 to 7.60)19 per 100033 per 1.000 (8 to 129)247 (3) Very low

Comment: The quality of evidence is downgraded by risk of bias (unclear sequence generation or allocation concealment) and by imprecise results (few outcome events).

    References

    • Smits RM, Mackenzie-Proctor R, Yazdani A et al. Antioxidants for male subfertility. Cochrane Database Syst Rev 2019;(3):CD007411. [PubMed]

Primary/Secondary Keywords