Abstract
Introduction: The role of nutraceuticals in the treatment of male infertility, especially in the “idiopathic form”, remains the subject of significant debate. Many antioxidants improve sperm motility but the exact mechanism by which they act is still unclear. Although several studies have shown a correlation between sperm motility and mitochondrial function, the effects of antioxidant therapy on mitochondrial membrane potential (MMP) are poorly studied. The first aim of this review was to evaluate the efficacy of antioxidants on mitochondrial function and, consequently, on sperm motility in male infertile patients. Material and Methods: we performed a systematic search of all randomized controlled and uncontrolled studies available in the literature that reported sperm motility and MMP at baseline and after antioxidant administration in-vivo and in-vitro in patients with idiopathic asthenozoospermia. Pubmed, MEDLINE, Cochrane, Academic One Files, Google Scholar and Scopus databases were used. Results: Unexpectedly, among 353 articles retrieved, only one study met our inclusion criteria and showed a significant effect of myoinositol on both MMP and sperm motility. We then summarized the main knowledge on anatomy and metabolism of sperm mitochondria, techniques allowing to assess sperm mitochondria function and its relationships with low sperm motility. Finally, we paid special attention to the effect of antioxidant/prokinetic molecules for the treatment of asthenozoospermia. Conclusions: This is the first systematic review that has attempted to evaluate the effects of antioxidants on MMP and sperm motility. Although results are not conclusive due to the dearth of studies, the close relationship between mitochondria and sperm motility is clear. The investigation of this correlation could provide valuable information to be exploited in clinical practice for the treatment of male infertility.
Highlights
The role of nutraceuticals in the treatment of male infertility, especially in the “idiopathic form”, remains the subject of significant debate
Several studies have shown a correlation between sperm motility and mitochondrial function, the effects of antioxidant therapy on the mitochondrial membrane (MMP) have rarely been studied
38 studies were excluded because only sperm motility was assessed and not mitochondrial function; four studies were excluded because no exclusion criteria were used for patient selection and one study did not report results on sperm motility
Summary
The role of nutraceuticals in the treatment of male infertility, especially in the “idiopathic form”, remains the subject of significant debate. Results are not conclusive due to the dearth of studies, the close relationship between mitochondria and sperm motility is clear The investigation of this correlation could provide valuable information to be exploited in clinical practice for the treatment of male infertility. Studies and interest for sperm motility started in 1919 when Lillie Frank Rattray, an American zoologist, author of the book “Problems of fertilization”, for the first time, talked on the energetic metabolism of spermatozoa He said: “Spermatozoa are probably incapable of receiving nourishment outside of the gonad after they are fully differentiated; certainly in the case of external insemination there is no opportunity for the restitution of substance . Since those years, several studies focused on the “power plant” of the cell, the mitochondrion, demonstrating the key role of this organelle on cellular homeostasis and sperm motility [1]. Mitochondrial sperm dysfunction is implicated in the pathogenesis of seminal oxidative stress, a key element responsible of many cases of “apparently” idiopathic male infertility [6]
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