The effect of selenium therapy on semen parameters in infertile men with varicocele

Year 2024, Volume: 41 Issue: 3, 606 - 610, 30.09.2024

Ahmed T Alahmar

Abstract

Oxidative stress and varicocele have been linked to male infertility. The aim of this study was to assess the effect of selenium therapy on semen parameters in infertile men with varicocele. Forty infertile men with varicocele (Group 1) and forty infertile men without varicocele (Controls, Group 2) with oligoasthenospermia who fulfilled the selection criteria were included in the study. All participants received selenium (200 µg/day) orally for three months. Seminal fluid analysis (WHO 5th criteria) was performed at baseline and after three months of selenium treatment. The results were compared between groups before and after therapy. Following three months of selenium therapy, sperm progressive motility significantly increased in patients with and without varicocele (P<0.01, P<0.05 respectively; 32.7% change vs. 24.1% respectively) but the improvement was higher in patients with varicocele. Similarly, sperm total motility significantly increased in patients with and without varicocele (P<0.01, P<0.05 respectively; 23.6% change vs. 12.6% respectively) and the increment was higher in infertile men with varicocele. Sperm concentration and normal sperm morphology; however, did not significantly change before and after selenium therapy. In conclusion, treatment of infertile men with varicocele and oligoasthenospermia with selenium (200 µg/day) for 3 months improves sperm progressive and total motility and the increment is higher than in infertile men without varicocele. Thus, selenium could be an adjuvant treatment for varicocele-associated male infertility.

Keywords

Selenium, male infertility, varicocele

Project Number

1111

References

• Stenqvist A, Oleszczuk K, Leijonhufvud I, Giwercman A. Impact of antioxidant treatment on DNA fragmentation index: a double-blind placebo-controlled randomized trial. Andrology 2018;6:811–6. https://doi.org/10.1111/ANDR.12547.
• Alahmar A, Calogero AE, Singh R, Cannarella R, Sengupta P, Dutta S. Coenzyme Q10, oxidative stress, and male infertility: A review. Clin Exp Reprod Med 2021;48:97–104. https://doi.org/10.5653/cerm.2020.04175.
• Agarwal A, Arafa M, Chandrakumar R, Majzoub A, AlSaid S, Elbardisi H. A multicenter study to evaluate oxidative stress by oxidation-reduction potential, a reliable and reproducible method. Andrology 2017;5:939–45. https://doi.org/10.1111/andr.12395.
• Kızılay F, Altay B. Evaluation of the effects of antioxidant treatment on sperm parameters and pregnancy rates in infertile patients after varicocelectomy: a randomized controlled trial. International Journal of Impotence Research 2019 31:6 2019;31:424–31. https://doi.org/10.1038/s41443-018-0109-4.
• World Health Organization. WHO laboratory manual for the examination and processing of human semen 2010.
• Festa R, Giacchi E, Raimondo S, Tiano L, Zuccarelli P, Silvestrini A, et al. Coenzyme Q 10 supplementation in infertile men with low-grade varicocele : an open , uncontrolled pilot study. Andrologi 2014;46:805–7. https://doi.org/10.1111/and.12152.
• Lira Neto FT, Roque M, Esteves SC. Effect of varicocelectomy on sperm deoxyribonucleic acid fragmentation rates in infertile men with clinical varicocele: a systematic review and meta-analysis. Fertil Steril 2021;116:696–712. https://doi.org/10.1016/j.fertnstert.2021.04.003.
• Cavallini G, Ferraretti AP, Gianaroli L, Biagiotti G, Vitali G. Cinnoxicam and l -Carnitine/Acetyl- l -Carnitine Treatment for Idiopathic and Varicocele-Associated Oligoasthenospermia. J Androl 2004;25:761–70. https://doi.org/10.1002/j.1939-4640.2004.tb02853.x.
• Zaazaa A, Adel A, Fahmy Y, Elkhiat Y, Awaad A, Mostafa T. Effect of varicocelectomy and/or mast cells stabilizer on sperm DNA fragmentation in infertile patients with varicocele. Andrology 2018;6:146–50.
• Kızılay F, Altay B. Evaluation of the effects of antioxidant treatment on sperm parameters and pregnancy rates in infertile patients after varicocelectomy: a randomized controlled trial. International Journal of Impotence Research 2019 31:6 2019;31:424–31. https://doi.org/10.1038/s41443-018-0109-4.
• Majzoub A, Agarwal A. Systematic review of antioxidant types and doses in male infertility : Benefits on semen parameters , advanced sperm function , assisted reproduction and live-birth rate. Arab J Urol 2018;16:113–24. https://doi.org/10.1016/j.aju.2017.11.013.
• Abad C, Amengual MJ, Gosálvez J, Coward K, Hannaoui N, Benet J, et al. Effects of oral antioxidant treatment upon the dynamics of human sperm DNA fragmentation and subpopulations of sperm with highly degraded DNA. Andrologia 2013;45:211–6. https://doi.org/10.1111/and.12003.
• Morbat M, Hadi A, Hadri D. Effect of Selenium in Treatment of Male Infertility. Experimental Techniques in Urology & Nephrology 2018;1.
• Cannarella R, Condorelli RA, Calogero AE, Bagnara V, Aversa A, Greco EA, et al. Effects of Selenium Supplementation on Sperm Parameters and DNA-Fragmentation Rate in Patients with Chronic Autoimmune Thyroiditis. J Clin Med 2021;10. https://doi.org/10.3390/jcm10163755.
• Alahmar A, Sengupta P. Impact of coenzyme Q10 and selenium on seminal fluid parameters and antioxidant status in men with idiopathic infertility. Biol Trace Elem Res 2021;199:1246–52.
• Esteves SC, Majzoub A, Agarwal A. Despite limitations, sperm DNA fragmentation testing provides unique information complementary to but distinct from semen analysis results. Transl Androl Urol 2017;6:S377--S378. https://doi.org/10.21037/tau.2017.05.04.
• Alahmar AT, Naemi R. Predictors of pregnancy and time to pregnancy in infertile men with idiopathic oligoasthenospermia pre- and post-coenzyme Q10 therapy. Andrologia 2022. https://doi.org/10.1111/AND.14385.
• Alahmar AT. The effects of oral antioxidants on the semen of men with idiopathic oligoasthenoteratozoospermia. Clin Exp Reprod Med 2018;45:57–66.
• Imamovic Kumalic S, Pinter B. Review of clinical trials on effects of oral antioxidants on basic semen and other parameters in idiopathic oligoasthenoteratozoospermia. Biomed Res Int 2014;2014:426951. https://doi.org/10.1155/2014/426951.
• Alahmar AT. The Effect of Selenium Therapy on Semen Parameters, Antioxidant Capacity, and Sperm DNA Fragmentation in Men with Idiopathic Oligoasthenoteratospermia. Biol Trace Elem Res 2023;201:5671–6. https://doi.org/10.1007/S12011-023-03638-8.
• Moslemi MK, Tavanbakhsh S. Selenium-vitamin E supplementation in infertile men: effects on semen parameters and pregnancy rate. Int J Gen Med 2011;4:99–104. https://doi.org/10.2147/IJGM.S16275.
• Hawkes WC, Alkan Z, Wong K. Selenium supplementation does not affect testicular selenium status or semen quality in North American men. J Androl 2009;30:525–33.
• Ghafarizadeh AA, Vaezi G, Shariatzadeh MA, Malekirad AA. Effect of in vitro selenium supplementation on sperm quality in asthenoteratozoospermic men. Andrologia 2018;50. https://doi.org/10.1111/and.12869.
• Nazari L, Salehpour S, Hosseini S, Allameh F, Jahanmardi F, Azizi E, et al. Effect of antioxidant supplementation containing L-carnitine on semen parameters: a prospective interventional study. JBRA Assist Reprod 2021;25:76–80. https://doi.org/10.5935/1518-0557.20200043.
• Ahmadi S, Bashiri R, Ghadiri-Anarip A, Nadjarzadehp A. Antioxidant supplements and semen parameters: An evidence based review. Int J Reprod Biomed 2016;14:729–36. https://doi.org/10.29252/ijrm.14.12.729.
• Agarwal A, Leisegang K, Majzoub A, Henkel R, Finelli R, Panner Selvam M, et al. Utility of Antioxidants in the Treatment of Male Infertility: Clinical Guidelines Based on a Systematic Review and Analysis of Evidence. World J Mens Health 2021;39:1–58. https://doi.org/10.5534/WJMH.200196.
• Ahsan U, Kamran Z, Raza I, Ahmad S, Babar W, Riaz MH, et al. Role of selenium in male reproduction—A review. Anim Reprod Sci 2014;146:55–62. https://doi.org/10.1016/j.anireprosci.2014.01.009.
• Gual-Frau J, Abad C, Amengual MJ, Hannaoui N, Checa MA, Ribas-Maynou J, et al. Oral antioxidant treatment partly improves integrity of human sperm DNA in infertile grade I varicocele patients. Hum Fertil (Camb) 2015;18:225–9. https://doi.org/10.3109/14647273.2015.1050462.
• Söylemez H, Kiliç S, Atar M, Penbegül N, Sancaktutar AA, Bozkurt Y. Effects of micronised purified flavonoid fraction on pain, semen analysis and scrotal color Doppler parameters in patients with painful varicocele; results of a randomized placebo-controlled study. Int Urol Nephrol 2012;44:401–8. https://doi.org/10.1007/S11255-011-0038-3.
• Oliva A, Dotta A, Multigner L. Pentoxifylline and antioxidants improve sperm quality in male patients with varicocele. Fertil Steril 2009;91:1536–9. https://doi.org/10.1016/j.fertnstert.2008.09.024.
• Taghizadeh L, Eidi A, Mortazavi P, Rohani AH. Effect of selenium on testicular damage induced by varicocele in adult male Wistar rats. Journal of Trace Elements in Medicine and Biology 2017;44:177–85. https://doi.org/10.1016/j.jtemb.2017.08.003.
• Freni J, Pallio G, Marini HR, Micali A, Irrera N, Romeo C, et al. Positive Effects of the Nutraceutical Association of Lycopene and Selenium in Experimental Varicocele. Int J Mol Sci 2023;24. https://doi.org/10.3390/IJMS241713526.