Применение комплекса нутриентов при идиопатическом мужском бесплодии в форме астено- и/или тератозооспермии: поиск предикторов эффективности лечения (предварительные результаты)

Abstract

Nutrient complexes (dietary supplements) containing various vitamins, minerals, enzymes are popular substances for treatment of male infertility. However, the use of such complexes often does not lead to an improvement of ejaculate analysis and the restoration of fertility. To determine the predictors of efficiency of treatment with a complex of nutrients. An open, uncontrolled study which included 102 men from infertile couples aged 25-45 years with idiopathic asteno-, and/or teratozoospermia was conducted. All man received the complex of nutrients (4 capsules of 410 mg per day) containing L-arginine (720 mg), L-carnitine (240 mg), L-carnosine (92 mg), coenzyme Q10 (10 mg), glycyrrhetinic acid (6 mg), zinc (4,8 mg), vitamin (3,2 mg), vitamin (0,36 mg), selenium (0,034 mg), which is from 12% to 80% of recommended level of daily intake for these substances. The ejaculate analysis was done in accordance to WHO recommendations, including the assessment of the production of reactive oxygen species (ROS). After 3 months of treatment the proportion of sperm cells with progressive motility increased in 59% patients in the average by 4 % (<0.05) due to an increase in the proportion of rapidly progressive sperms with grade "A" motility by 4 % (<0,05) and a decrease in the proportion of non-progressive sperms (-2 %; <0.05). The improvement was more often observed in patients with baseline lower sperm motility (<0,05) and had phasic dependence on the ROS level. It was more pronounced (+24 % in relative values for motility "A"; <0.05) in patients with moderate elevation of ROS level (2-4 IU), and insignificant at the normal (< 2 IU) and marked elevated (4-7 >7 IU) ROS level. The standardized effect with an increase of ROS for motile spermatozoa of category A was 0.16, 0.47, 0.34 0.22, respectively, i.e., it was weak in all cases. The changes of sperm concentration and morphology were insignificant (>0.05), but the improvement of sperm morphology was more often observed in patients with pathologic forms greater than 95 % (<0.05). The increase in the proportion of sperm cells with progressive motility while taking nutrient complex had dependence on the baseline level of oxidative stress and it was more pronounced in patients with moderate elevation of ROS level. The further, more powerful studies to assess the influence of dietary of this supplement on the other ejaculate indicators.