Abstract
Background: Selenium (Se) is an essential component of selenoenzymes, which have catalytic and antioxidant functions. A low Se status has been reported in patients with chronic autoimmune thyroiditis (AT) who benefit from Se supplementation. The role of Se in male reproduction is still a matter of debate. Although Se and selenoenzymes ensure sperm viability and protect against increased oxidative stress, only a few studies have assessed the effects of the administration of Se alone on sperm parameters, providing contrasting results. Aim: The aim of this study was to assess the effects of oral Se supplementation on conventional sperm parameters and DNA fragmentation (SDF) in patients with AT of reproductive age with normal thyroid function. Patients and Methods: Only patients with AT and normal thyroid function were selected for this study. All included patients underwent oral Se supplementation at the dose of 83 µg once daily (Syrel®, IBSA) for six months. Sperm conventional parameters, SDF, and thyroid function were assessed before and at the end of the treatment. Results: Twenty AT patients with normal weight were enrolled. After Se supplementation, they showed a higher sperm concentration, a higher percentage of sperm with progressive motility, and a higher percentage with normal morphology. They also had lower semen leukocyte concentration, and a lower percentage of spermatozoa with DNA fragmentation compared with pre-treatment values. Free-thyroxine serum levels increased significantly, whereas free triiodothyronine showed an upward trend. The thyroid-stimulating hormone did not change significantly. Conclusion: Se supplementation may represent a possible non-hormonal therapeutic choice for the treatment of male infertility, although further studies are needed to confirm this evidence. The possible thyroid hormone dependency of these findings needs to be clarified.
Highlights
Male infertility is widespread in industrialized countries, with an increasing prevalence estimated at 7% in 2011, and up to 12% in recent years [1]
(4.5 ± 2.4 vs. 5.8 ± 2.0, p < 0.005). They showed a lower concentration of leukocytes in the seminal fluid (0.8 ± 0.1 vs. 0.4 ± 0.3, p < 0.0005), and a lower percentage of spermatozoa with DNA fragmentation (3.9 ± 0.2 vs. 2.9 ± 1.6, p < 0.01) compared to pre-treatment values
The prevalence of teratozoospermia was significantly reduced after treatment compared to pre-treatment values (45% vs. 10%, p < 0.05)
Summary
Male infertility is widespread in industrialized countries, with an increasing prevalence estimated at 7% in 2011, and up to 12% in recent years [1]. Non-hormonal treatment of male infertility includes antibiotics, fibrinolytic, and antioxidants [2], the latter including nutrients and minerals. Selenium (Se) is a micronutrient and a component of the so-called “selenoproteins”, or selenium-containing enzymes with a wide range of functions ranging from antioxidant and anti-inflammatory properties to the synthesis of thyroid hormones [3]. As for the latter, Se can enhance the enzymatic activity of various proteins involved in the synthesis of thyroid hormones, such as deiodinases. Se stimulates type 1 and 2 deiodinase to convert thyroxine into triiodothyronine by removing 50 -iodine, and stimulates type 3, which inactivates triiodothyronine by 50 -deiodination [3]
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