Semen analysis is often performed as the first step in the initial evaluation of male fertility and its use dates back several hundred years. Currently, the most commonly evaluated semen parameters are semen volume, sperm density (Aka count), sperm motility and sperm shape (aka morphology). Abnormalities of count, motility and shape are referred to as: oligoasthenoteratozoospermia also known as OATS. One theory behind the underlying mechanism of OATS is the presence of “oxidative stress” due to the presence of “Reactive Oxygen Species (ROS)” which overwhelm cellular metabolism. Therefore, the use of a large number of anti-oxidants have been used in an attempt to remedy male infertility. Selenium, Carnitine and Coenzyme Q 10 are frequently used antioxidants.
A retrospective review of 20 appropriate studies with respect to using these three antioxidants was conducted Results were as follows:
Total motility: Twelve studies showed increased total sperm motility
Progressive Motility: Nine studies showed increased sperm progressive motility
Concentration: Seventeen studies showed higher sperm Concentration
Semen Volume was found to be unchanged.
Pregnancy rate: Available from 12 studies with 800 subjects: No statistically significant difference.
Conclusion: The authors looked at several different studies which also looked at the effect of antioxidants with various findings; however, criticisms of the other studies included a lack of robustness in the data. Even reflecting on the current report was the observation that different criteria for semen analysis were used in different studiess.
It is interesting to me that the authors did not comment on the fact that modest improvements in semen analysis may not correlate with improvement in pregnancy rates. That is a reason why, in my practice I use both semen analysis and Cap-score as fundamental tests for the evaluation of sperm. The question remains whether supplements and or lifestyle changes can also improve cap-score to a significant degree. In the near future my office is planning on participating in a study that will address that question.
