Abstract

Background: An elevated DNA Fragmentation Index (DFI) has been associated with male infertility; therefore measuring the sperm nuclear DNA integrity appears to be useful in predicting the ability of spermatozoa to fertilize oocytes.Aim: To evaluate the effect of micronutrient supplementation over DFI values in subfertile men.Methods: This was a retrospective/comparative study that included a total of 306 subfertile males consulting the clinic from March 2011 to November 2017, who had performed the Sperm Chromatin Dispersion test (SCD) — a method used to detect DNA fragmentation — along with the initial semen analysis. Of the included population, [Formula: see text] 146 had received two daily oral capsules of a standardized combined micronutrient compound ([Formula: see text], Lenus Pharma, Vienna, Austria) for three months plus lifestyle change (study group). Each capsule contains L-carnitine, L-arginine, coenzyme Q10, zinc, vitamin E, folic acid, glutathione and selenium. Those who did not receive the active treatment ([Formula: see text] 160) but only engaged with lifestyle changes were considered controls. The SCD test was performed in both groups at baseline and after 3 months.Results: For the first statistical analysis, patients with an initial mean DFI of >15% were considered ([Formula: see text] 66 [37 were study and 29 were controls]). After 3 months, both groups displayed a significant decrease of mean DFI values. However, this decrease was more evident in the study group as compared to controls (10.54% vs. 14.48%, [Formula: see text] 0.05; [Formula: see text] 0.013). For the second statistical approach the entire population was considered ([Formula: see text] 306). After 3 months, only the study group displayed a significant decrease of the mean initial DFI value (10.16% to 6.49%, [Formula: see text] < 0.0001); decrease that was more evident as compared to controls (6.49% vs. 8.82%, [Formula: see text] 0.05; [Formula: see text] 0.000020).Conclusions: Among subfertile men with a DFI >15%, both regimes significantly decreased sperm DNA fragmentation; however, when any baseline DFI value was considered, only treatment with the active standardized micronutrient compound achieved a significant better result.

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