Effects of Vitamin E and Vitamin C on Male Infertility: a Meta-analysis

Overview

Journal Int Urol Nephrol

Publisher Springer

Specialty Nephrology

Date 2022 May 23

PMID 35604582

Authors

Xianling Zhou

Heng Shi

Shiping Zhu

Haixia Wang

Shengyun Sun

Affiliations

Soon will be listed here.

Abstract

Purpose: The efficacy of the antioxidants vitamin E (VitE) and vitamin C (VitC) on male infertility is uncertain. Therefore, this research systematically assessed the influences of VitE and VitC on male infertility.

Methods: We did a meta-analysis of randomized controlled trials (RCTs) to analyze semen parameters, pregnancy rate, and adverse effects (AEs) between VitE and VitC groups and control groups by searching Cochrane Library, Excerpta Medica Database (Embase), PubMed, China Biology Medicine disc (CBMdisc), and Web of Science up to June 2020.

Results: We screened 11 studies (832 patients) that met the inclusion criteria. The evidence quality ranged from moderate to low. The pregnancy rate was obviously better in the VitE group than in the control group (relative risk (RR) 1.86, 95% confidence interval (CI) 1.02-3.41). Compared with the control group, VitE and VitC significantly improved progressive motility (standardized mean difference (SMD) 0.38, 95% CI 0.22-0.55), sperm concentration (SMD 0.21, 95% CI 0.09-0.34), sperm morphology (SMD 0.32, 95% CI 0.09-0.55), and total sperm number (SMD 0.28, 95% CI 0.12-0.43) without AEs.

Conclusion: This study suggests that VitC and VitE can improve the spousal pregnancy rate and semen parameters in infertile men without AEs.

Citing Articles

The Contribution of Precision Nutrition Intervention in Subfertile Couples.

Monteiro J, Bicho M, Valente A Nutrients. 2025; 17(1.

PMID: 39796537 PMC: 11722978. DOI: 10.3390/nu17010103.

Platelet Mitochondrial Function and Endogenous Coenzyme Q Levels Could Be Used as Markers of Mitochondrial Health in Infertile Men: A Pilot Study.

Sumbalova Z, Rausova Z, Kucharska J, Sranko P, Harbulak P, Svitok P Int J Mol Sci. 2025; 26(1.

PMID: 39796125 PMC: 11720540. DOI: 10.3390/ijms26010268.

From Hypoxia to Oxidative Stress: Antioxidants' Role to Reduce Male Reproductive Damage.

Li S, Liu W, Chen X, Chen Z, Shi J, Hua J Reprod Sci. 2024; 32(2):261-277.

PMID: 39557807 DOI: 10.1007/s43032-024-01746-x.

A Dietary Supplement Jinghuosu Ameliorates Reproductive Damage Induced by Tripterygium Glycosides.

Ma J, Sun B, Te L, Huang X, Zuo X, Han X Chin J Integr Med. 2024; 30(4):330-338.

PMID: 38212501 DOI: 10.1007/s11655-023-3750-9.

Antioxidants positively regulate obesity dependent circRNAs - sperm quality - functional axis.

Mele V, Chioccarelli T, Finamore R, DAgostino A, DAgostino M, Cimini D Front Endocrinol (Lausanne). 2024; 14:1290971.

PMID: 38169845 PMC: 10758610. DOI: 10.3389/fendo.2023.1290971.

References

Pierik F, van Ginneken A, Dohle G, Vreeburg J, WEBER R . The advantages of standardized evaluation of male infertility. Int J Androl. 2000; 23(6):340-6. DOI: 10.1046/j.1365-2605.2000.00250.x. View

Tremellen K . Oxidative stress and male infertility--a clinical perspective. Hum Reprod Update. 2008; 14(3):243-58. DOI: 10.1093/humupd/dmn004. View

Barati E, Nikzad H, Karimian M . Oxidative stress and male infertility: current knowledge of pathophysiology and role of antioxidant therapy in disease management. Cell Mol Life Sci. 2019; 77(1):93-113. PMC: 11105059. DOI: 10.1007/s00018-019-03253-8. View

Agarwal A, Prabakaran S, Said T . Prevention of oxidative stress injury to sperm. J Androl. 2005; 26(6):654-60. DOI: 10.2164/jandrol.05016. View

Kao S, Chao H, Chen H, Hwang T, Liao T, Wei Y . Increase of oxidative stress in human sperm with lower motility. Fertil Steril. 2007; 89(5):1183-1190. DOI: 10.1016/j.fertnstert.2007.05.029. View

Ross C, Morriss A, Khairy M, Khalaf Y, Braude P, Coomarasamy A . A systematic review of the effect of oral antioxidants on male infertility. Reprod Biomed Online. 2010; 20(6):711-23. DOI: 10.1016/j.rbmo.2010.03.008. View

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. PMC: 3988936. DOI: 10.1155/2014/426951. View

Aitken J, Fisher H . Reactive oxygen species generation and human spermatozoa: the balance of benefit and risk. Bioessays. 1994; 16(4):259-67. DOI: 10.1002/bies.950160409. View

Rafiee B, Morowvat M, Rahimi-Ghalati N . Comparing the Effectiveness of Dietary Vitamin C and Exercise Interventions on Fertility Parameters in Normal Obese Men. Urol J. 2016; 13(2):2635-9. View

10.

Akmal M, Qadri J, Al-Waili N, Thangal S, Haq A, Saloom K . Improvement in human semen quality after oral supplementation of vitamin C. J Med Food. 2006; 9(3):440-2. DOI: 10.1089/jmf.2006.9.440. View

11.

Schmid T, Eskenazi B, Marchetti F, Young S, Weldon R, Baumgartner A . Micronutrients intake is associated with improved sperm DNA quality in older men. Fertil Steril. 2012; 98(5):1130-7.e1. DOI: 10.1016/j.fertnstert.2012.07.1126. View

12.

ElSheikh M, Hosny M, Elshenoufy A, Elghamrawi H, Fayad A, Abdelrahman S . Combination of vitamin E and clomiphene citrate in treating patients with idiopathic oligoasthenozoospermia: A prospective, randomized trial. Andrology. 2015; 3(5):864-7. DOI: 10.1111/andr.12086. View

13.

Ghanem H, Shaeer O, El-Segini A . Combination clomiphene citrate and antioxidant therapy for idiopathic male infertility: a randomized controlled trial. Fertil Steril. 2009; 93(7):2232-5. DOI: 10.1016/j.fertnstert.2009.01.117. View

14.

Higgins J, Altman D, Gotzsche P, Juni P, Moher D, Oxman A . The Cochrane Collaboration's tool for assessing risk of bias in randomised trials. BMJ. 2011; 343:d5928. PMC: 3196245. DOI: 10.1136/bmj.d5928. View

15.

Whitlock R, Chan S, Devereaux P, Sun J, Rubens F, Thorlund K . Clinical benefit of steroid use in patients undergoing cardiopulmonary bypass: a meta-analysis of randomized trials. Eur Heart J. 2008; 29(21):2592-600. DOI: 10.1093/eurheartj/ehn333. View

16.

Higgins J, Thompson S, Deeks J, Altman D . Measuring inconsistency in meta-analyses. BMJ. 2003; 327(7414):557-60. PMC: 192859. DOI: 10.1136/bmj.327.7414.557. View

17.

Higgins J, Thompson S . Quantifying heterogeneity in a meta-analysis. Stat Med. 2002; 21(11):1539-58. DOI: 10.1002/sim.1186. View

18.

DerSimonian R, Laird N . Meta-analysis in clinical trials. Control Clin Trials. 1986; 7(3):177-88. DOI: 10.1016/0197-2456(86)90046-2. View

19.

Egger M, Davey Smith G, Schneider M, Minder C . Bias in meta-analysis detected by a simple, graphical test. BMJ. 1997; 315(7109):629-34. PMC: 2127453. DOI: 10.1136/bmj.315.7109.629. View

20.

Duval S, Tweedie R . Trim and fill: A simple funnel-plot-based method of testing and adjusting for publication bias in meta-analysis. Biometrics. 2000; 56(2):455-63. DOI: 10.1111/j.0006-341x.2000.00455.x. View