Highly Cited Articles in the Field of Male Infertility and Antioxidants: A Scientometric Analysis (original) (raw)
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The World Journal of Men's Health, 2021
It is widely accepted that oxidative stress plays an important role in the pathophysiology of male infertility and that antioxidants could have a significant role in the treatment of male infertility. The main objectives of this study are: 1) to systematically review the current evidence for the utility of antioxidants in the treatment of male infertility; and 2) propose evidence-based clinical guidelines for the use of antioxidants in the treatment of male infertility. A systematic review of the available clinical evidence was performed, with articles published on Scopus being manually screened. Data extracted included the type of antioxidant used, the clinical conditions under investigation, the evaluation of semen parameters and reproductive outcomes. The adherence to the Cambridge Quality Checklist, Cochrane Risk of Bias for randomized controlled trials (RCTs), CONSORT guidelines and JADAD score were analyzed for each included study. Further, we provided a Strength Weakness Opportunity Threat (SWOT) analysis to analyze the current and future value of antioxidants in male infertility. Of the 1,978 articles identified, 97 articles were included in the study. Of these, 52 (53.6%) were uncontrolled (open label), 12 (12.4%) unblinded RCTs, and 33 (34.0%) blinded RCTs, whereas 44 (45.4%) articles tested individual antioxidants, 31 (32.0%) a combination of several products in variable dosages, and 22 (22.6%) registered antioxidant products. Based on the published evidence, we 1) critically examined the necessity of additional double-blind, randomized, placebo-controlled trials, and 2) proposed updated evidence-based clinical guidelines for antioxidant therapy in male infertility. The current systematic review on antioxidants and male infertility clearly shows that antioxidant supplementation improves semen parameters. In addition, it provides the indications for antioxidant treatment in specific clinical conditions, including varicocele, unexplained and idiopathic male infertility, as well as in cases of altered semen quality.
Antioxidant therapy in male infertility: fact or fiction?
Asian Journal of Andrology, 2011
Infertile men have higher levels of semen reactive oxygen species (ROS) than do fertile men. High levels of semen ROS can cause sperm dysfunction, sperm DNA damage and reduced male reproductive potential. This observation has led clinicians to treat infertile men with antioxidant supplements. The purpose of this article is to discuss the rationale for antioxidant therapy in infertile men and to evaluate the data on the efficacy of dietary and in vitro antioxidant preparations on sperm function and DNA damage. To date, most clinical studies suggest that dietary antioxidant supplements are beneficial in terms of improving sperm function and DNA integrity. However, the exact mechanism of action of dietary antioxidants and the optimal dietary supplement have not been established. Moreover, most of the clinical studies are small and few have evaluated pregnancy rates. A beneficial effect of in vitro antioxidant supplements in protecting spermatozoa from exogenous oxidants has been demonstrated in most studies; however, the effect of these antioxidants in protecting sperm from endogenous ROS, gentle sperm processing and cryopreservation has not been established conclusively.
Antioxidants, 2021
Under physiological conditions, reactive oxygen species (ROS) play pivotal roles in various processes of human spermatozoa. Indeed, semen requires the intervention of ROS to accomplish different stages of its maturation. However, ROS overproduction is a well-documented phenomenon occurring in the semen of infertile males, potentially causing permanent oxidative damages to a vast number of biological molecules (proteins, nucleic acids, polyunsaturated fatty acids of biological membrane lipids), negatively affecting the functionality and vitality of spermatozoa. ROS overproduction may concomitantly occur to the excess generation of reactive nitrogen species (RNS), leading to oxidative/nitrosative stress and frequently encountered in various human pathologies. Under different conditions of male infertility, very frequently accompanied by morpho-functional anomalies in the sperm analysis, several studies have provided evidence for clear biochemical signs of damages to biomolecules cause...
The World Journal of Men's Health
The use of antioxidants is common practice in the management of infertile patients. However, there are no established guidelines by professional societies on antioxidant use for male infertility. Materials and Methods: Materials and Methods: Using an online survey, this study aimed to evaluate the practice pattern of reproductive specialists to determine the clinical utility of oxidative stress (OS) testing and antioxidant prescriptions to treat male infertility. Results: Results: Responses from 1,327 participants representing 6 continents, showed the largest participant representation being from Asia (46.8%). The majority of participants were attending physicians (59.6%), with 61.3% having more than 10 years of experience in the field of male infertility. Approximately two-thirds of clinicians (65.7%) participated in this survey did not order any diagnostic tests for OS. Sperm DNA fragmentation was the most common infertility test beyond a semen analysis that was prescribed to study oxidative stress-related dysfunctions (53.4%). OS was mainly tested in the presence of lifestyle risk factors (24.6%) or sperm abnormalities (16.3%). Interestingly, antioxidants were prescribed by 85.6% of clinicians, for a duration of 3 (43.7%) or 3-6 months (38.6%). A large variety of antioxidants and dietary supplements were prescribed, and scientific evidence were mostly considered to be modest to support their clinical use. Results were not influenced by the physician's age, geographic origin, experience or training in male infertility. Conclusions: Conclusions: This study is the largest online survey performed to date on this topic and demonstrates 1) a worldwide understanding of the importance of this therapeutic option, and 2) a widely prevalent use of antioxidants to treat male infertility. Finally, the necessity of evidence-based clinical practice guidelines from professional societies is highlighted.
The role of antioxidant therapy in the treatment of male infertility: an overview
Asian Journal of Andrology, 2011
In recent years, many studies have focused on the effect of oxidative stress, reactive oxygen species (ROS) and antioxidants on the male eproductive system. Under physiological conditions, sperm produces small amounts of ROS, which are needed for fertilisation, acrosome reaction and capacitation. However, if an increased production of ROS is not associated with a similar increase in scavenging systems, peroxidative damage of the sperm plasma membrane and loss of DNA integrity typically occur, which leads to cell death and reduced fertility. Furthermore, since there is no linear correlation between sperm quality and pregnancy rates, an improvement in semen parameters should not be the sole outcome considered in studies of antioxidant therapies. A definitive conclusion regarding the benefit of these therapies is difficult to obtain, as most of the previous studies lacked control groups, considered different antioxidants in different combinations and doses, or did not evaluate pregnancy rates in previously infertile couples. Even if beneficial effects were reported in a few cases of male infertility, more multicentre, double-blind studies performed with the same criteria are necessary for an increased understanding of the effects of various antioxidants on fertility.
Antioxidant therapy for male subfertility: myth or evidence-based?
Trends in Urology & Men's Health, 2015
The authors review the literature investigating the role of common dietary supplements that are being marketed as a remedy for male subfertility. They assess the evidence base supporting their use and their potential role in improving semen parameters alongside overall conception and live-birth rates.
Antioxidants in the treatment of male infertility
Health of Man, 2018
By affecting the process of spermatogenesis, several genetic, environmental, physiological and nutritional factors can reduce sperm quality and quantity and cause male infertility. The present study aimed to summarize studies conducted on the epidemiological and pathophysiological causes of male infertility, the effects of oxidative stress on poor sperm function and the role of antioxidants in the treatment of male infertility. In the present meta-analysis, the following key words were searched on PubMed, Google scholar, Scopus and Web of Science (1993-2013): male reproductive, male infertility, treatment for male infertility, antioxidant, role of antioxidant therapy, oxidative stress, antioxidant treatment in male fertility, oxidative stress and male infertility and effects of oral antioxidants on sperm quality. Oxidative stress is created by Reactive Oxygen Species (ROS) or free radicals. Although small amounts of ROS are required for sperm functioning, high levels of ROS can affect semen quality which is responsible for %25 of male infertility cases. However, there are antioxidants that have control over the production of ROS and the process of lipid peroxidation by collecting ROS and balancing useful oxidants creating oxidative stress. Thus, using these antioxidants has been recommended for the treatment of male infertility. the administration of L-Carnitine, Selenium, Vitamin E, Vitamin C, Glutathione and coenzyme Q10, as antioxidants, has been proven effective for improving sperm parameters.
A systematic review of the effect of oral antioxidants on male infertility
Reproductive BioMedicine Online, 2010
is a Consultant in reproductive medicine and surgery and pre-implantation genetic diagnosis (PGD) at the Assisted Conception Unit at Guy's and St Thomas' Hospital in London, UK. His clinical and research interests are in the fields of recurrent IVF implantation failure, prevention of ovarian hyperstimulation syndrome, PGD and minimal access surgery. He has published over 80 original articles, reviews and opinion papers.
Antioxidants
Antioxidant therapy should be reserved for infertile patients who actually exhibit signs of oxidative stress (OS). Nevertheless, there is no consensus regarding the measure of the primary endpoint and the assay that should be used. The formation of 8-hydroxy-2′-deoxyguanosine (8-OHdG), an early marker of sperm DNA oxidation (SDO), was analyzed using flow cytometry, in men at a University hospital setup for infertility treatment. Similar to conventional semen parameters, 8-OHdG assay was validated on fresh semen samples to reduce the variability of results. SDO was associated with semen volume, sperm concentration, leucocytes and round cells, but not with age, body mass index, sperm DNA fragmentation (SDF) or OS. Whether the semen samples were normal or subnormal according to the WHO criteria, the expression of 8-OHdG was not different. Receiver operating characteristic curve analysis could discriminate two independent populations. Both SDF and SDO were independently expressed. A hig...
Efficacy of combined antioxidant therapy in male subfertility-A systematic review and meta-analysis
Cellular and Molecular Biology
Antioxidant therapy is a potentially promising approach to improve clinical outcomes for couples undergoing assisted reproduction techniques long-term. The review aims to (a) collate evidence for the effectiveness of combined oral antioxidant supplementation, including a head-to-head comparison in the treatment of male subfertility, and (b) investigate whether other intervention features, including duration, specific combinations, or dosage affect clinical outcomes in this population. Randomized controlled trials (RCTs) that examined the effectiveness of combined antioxidants on male subfertility, electronic databases including PubMed, Embase, CINAHL, PSYCHINFO, and Cochrane Central Register of Controlled Trials (CENTRAL) were searched. We also searched for unpublished data and references of identified articles. Two reviewers screened eligible studies according to pre-defined criteria and relevant data extracted. The Jadad scale assessed the quality of studies. The study used RevMan...