Pharmacologic and Nutritional Therapies in Idiopathic Male Infertility: A Systematic Review and Meta-Analysis.
Samar J Melhem, Motaz Melhem, Ra'ed Haddad et al.
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In 30 seconds
This systematic review and meta-analysis evaluated the effectiveness of pharmacologic and nutritional therapies on semen parameters in men with idiopathic infertility. Analyzing 41 randomized controlled trials involving 3615 men, the study found that antioxidants were associated with higher sperm concentration (SMD: 1.09) and motility, although the certainty of evidence was very low and prediction intervals were wide.
Key findings
- Antioxidants improved sperm concentration (SMD: 1.09) and progressive motility (SMD: 1.11).
- PDE inhibitors showed higher point estimates for sperm concentration (SMD: 1.96) and morphology (SMD: 1.28).
- Methyl donors reduced DNA fragmentation (SMD: -1.17), but confidence intervals included the null.
- Substantial heterogeneity was observed (I² > 80%).
Why it matters
Understanding the effectiveness of various interventions for idiopathic male infertility is crucial for clinicians to guide treatment decisions. This study highlights the potential role of antioxidants in improving semen parameters, although the evidence remains uncertain.
What to keep in mind
The study's findings are limited by low certainty of evidence and wide prediction intervals, indicating variability in individual responses.