Fulltext

A Global Survey of Reproductive Specialists to Determine the Clinical Utility of Oxidative Stress Testing and Antioxidant Use in Male Infertility

Agarwal A 1 , Finelli R 2 , Selvam MKP 2 , Leisegang K 3 , Majzoub A 4 , Tadros N 5 Show all authors , Ko E 6 , Parekh N 7 , Henkel R 2 , Durairajanayagam D 8 , Colpi GM 9 , Cho CL 10 , Sallam HN 11 , Park HJ 12 , Saleh R 13 , Micic S 14 , Ambar RF 15 , Zini A 16 , Tremellen K 17 , Alvarez JG 18 , Palani A 19 , Arafa M 2 , Gava MM 15 , Jindal S 20 , Amar E 21 , Kopa Z 22 , Moein MR 23 , Busetto GM 24 , Sengupta P 25 , Kavoussi P 26 , Maldonado I 27 , Fikri J 28 , Borges E 29 , Martinez M 30 , Bojovic D 31 , Rajmil O 32 , Aydos K 33 , Parekattil S 34 , Marmar JL 35 , Sefrioui O 36 , Jungwirth A 37 , Peña MGR 38 , Cordts EB 39 , Elbardisi H 4 , Mostafa T 40 , Sabbaghian M 41 , Sadighi Gilani MA 41 , Morimoto Y 42 , Alves MG 43 , Spasic A 44 , Kenic U 45 , Ramsay J 46 , Akande EO 47 , Oumeziane A 48 , Dozortsev D 49 , Chung E 50 , Bell EG 51 , Allegra A 52 , Tanos V 53 , Fiadjoe M 54 , Gurgan T 55 , Abou-Abdallah M 56 , Al-Rumaih H 57 , Oborna I 58 , Arab H 59 , Esteves S 60 , Amer M 40 , Kadioglu A 61 , Yuzko O 62 , Korsak V 63 , Shah R 64

Affiliations 

  • 1 American Center for Reproductive Medicine, Cleveland Clinic, Ohio, USA. agarwaa@ccf.org
  • 2 American Center for Reproductive Medicine, Cleveland Clinic, Ohio, USA
  • 3 School of Natural Medicine, University of the Western Cape, South Africa
  • 4 Department of Urology, Hamad Medical Corporation, Doha, Qatar
  • 5 Division of Urology, Southern Illinois University School of Medicine, Springfield, IL, USA
  • 6 Department of Urology, Loma Linda University Health, Loma Linda, CA, USA
  • 7 Department of Urology, Cleveland Clinic, Cleveland, OH, USA
  • 8 Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh Campus, Selangor, Malaysia
  • 9 Andrology and IVF Unit, Procrea Institute, Lugano, Switzerland
  • 10 S. H. Ho Urology Centre, Department of Surgery, The Chinese University of Hong Kong, Hong Kong
  • 11 Alexandria University Faculty of Medicine, Alexandria, Egypt
  • 12 Department of Urology, Pusan National University School of Medicine, Busan, Korea
  • 13 Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Sohag University, Sohag, Egypt
  • 14 Uromedica Polyclinic, Andrology Department, Belgrade, Serbia
  • 15 Sexual and Reproductive Medicine, Department of Urology, Faculdade de Medicina do ABC, Santo André, Brazil
  • 16 Department of Surgery, McGill University, St. Mary's Hospital, Montreal, QC, Canada
  • 17 Department of Obstetrics Gynaecology and Reproductive Medicine, Flinders University, Bedford Park, South Australia
  • 18 Centro ANDROGEN, La Coruro, Spain
  • 19 Department of Biochemistry, College of Medicine, University of Garmian, Kalar, Iraq
  • 20 Department of Andrology and Reproductive Medicine, Jindal Hospital, Meerut, India
  • 21 Cabinet D'Andrologie Victor Hugo, American Hospital of Paris Reproductive Center, Paris, France
  • 22 Andrology Centre, Department of Urology, Semmelweis University, Budapest, Hungary
  • 23 Yazd Research and Clinical Center for Infertility, Yazd, Iran
  • 24 Department of Urology and Renal Transplantation, University of Foggia Policlinico Riuniti of Foggia, Foggia, Italy
  • 25 Department of Physiology, Faculty of Medicine, Bioscience and Nursing, MAHSA University, Kuala Lumpur, Malaysia
  • 26 Austin Fertility & Reproductive Medicine/Westlake IVF, Austin, TX, USA
  • 27 Citmer Reproductive Medicine, IVF LAB, Mexico City, Mexico
  • 28 IVF Unit, Al Boustane Clinic, Rabat, Morocco
  • 29 Fertility Medical Group, Sapientiae Institute, São Paulo, Brazil
  • 30 Department of Urology, University of Santo Tomas Hospital, Manila, Philippines
  • 31 GAO Bojović, Belgrade, Serbia
  • 32 Deparment of Andrology, Fundacio Puigvert, Barcelona, Spain
  • 33 Department of Urology, University of Ankara, Ankara, Turkey
  • 34 Avant Concierge Urology & University of Central Florida, Winter Garden, FL, USA
  • 35 Honorary Staff of Cooper University Hospital, Camden, NJ, USA
  • 36 Anfa Fertility Center, Casablanca, Morocco
  • 37 St. Barbara Clinic, Bad Vigaun, Austria
  • 38 Andrology Unit, Instituto De Ginecologia y Fertilidad (IFER), Buenos Aires, Argentina
  • 39 Instituto Ideia Fertil-Human Reproduction Centre-Faculdade de Medicina do ABC, Sao Paulo, Brazil
  • 40 Department of Andrology, Sexology & STIs, Faculty of Medicine, Cairo University, Cairo, Egypt
  • 41 Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
  • 42 IVF Japan Group, HORAC Grand Front Osaka Clinic, Osaka, Japan
  • 43 Department of Anatomy and Unit for Multidisciplinary Research in Biomedicine (UMIB), Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto, Porto, Portugal
  • 44 Department of Urology, Military Medical Academy, Belgrade, Serbia
  • 45 Urology VUK Center, Belgrade, Serbia
  • 46 Department of Andrology, Hammersmith Hospital, London, UK
  • 47 Department of Obstetrics & Gynaecology, University College Hospital, Ibadan, Nigeria
  • 48 Tiziri IVF Center, Algeriers, Algeria
  • 49 American College of Embryology, Houston, TX, USA
  • 50 Department of Urology, University of Queensland, Brisbane, Australia
  • 51 Odyssèe Clinic for Assisted Reproduction, Douala, Cameroun
  • 52 ANDROS Day Surgery Clinic, Reproductive Medicine Unit, Palermo, Italy
  • 53 Department of Obstetrics and Gynecology, University of Nicosia Medical School, Nicosia, Cyprus
  • 54 Biasa Fertility Clinic, Lomè, Togo
  • 55 Department of Obstetrics and Gynecology, Bahcesehir University, Istanbul, Turkey
  • 56 Middle East Fertility Society, Canadian Foundation for Reproductive Medicine, Lebanon
  • 57 Reproductive Medicine Unit, New Jahra Hospital, Ministry of Health, Al Jahra, Kuwait
  • 58 Fertimed Ltd., Olomouc, Czech Republic
  • 59 RMU Dr. Arab Medical Center, Jeddah, Saudi Arabia
  • 60 ANDROFERT, Andrology & Human Reproduction Clinic, Campinas, Brazil
  • 61 Section of Andrology, Istanbul Faculty of Medicine, Istanbul, Turkey
  • 62 Department of Obstetrics and Gynecology, Bukovinian State Medical University, Chernivtsi, Ukraine
  • 63 International Centre for Reproductive Medicine, Saint-Petersburg, Russia
  • 64 Department of Urology, Lilavati Hospital and Research Centre, Mumbai, India
World J Mens Health, 2021 Jul;39(3):470-488.
PMID: 33831977 DOI: 10.5534/wjmh.210025

Abstract

PURPOSE: The use of antioxidants is common practice in the management of infertile patients. However, there are no established guidelines by professional societies on antioxidant use for male infertility.

MATERIALS AND METHODS: Using an online survey, this study aimed to evaluate the practice pattern of reproductive specialists to determine the clinical utility of oxidative stress (OS) testing and antioxidant prescriptions to treat male infertility.

RESULTS: Responses from 1,327 participants representing 6 continents, showed the largest participant representation being from Asia (46.8%). The majority of participants were attending physicians (59.6%), with 61.3% having more than 10 years of experience in the field of male infertility. Approximately two-thirds of clinicians (65.7%) participated in this survey did not order any diagnostic tests for OS. Sperm DNA fragmentation was the most common infertility test beyond a semen analysis that was prescribed to study oxidative stress-related dysfunctions (53.4%). OS was mainly tested in the presence of lifestyle risk factors (24.6%) or sperm abnormalities (16.3%). Interestingly, antioxidants were prescribed by 85.6% of clinicians, for a duration of 3 (43.7%) or 3-6 months (38.6%). A large variety of antioxidants and dietary supplements were prescribed, and scientific evidence were mostly considered to be modest to support their clinical use. Results were not influenced by the physician's age, geographic origin, experience or training in male infertility.

CONCLUSIONS: This study is the largest online survey performed to date on this topic and demonstrates 1) a worldwide understanding of the importance of this therapeutic option, and 2) a widely prevalent use of antioxidants to treat male infertility. Finally, the necessity of evidence-based clinical practice guidelines from professional societies is highlighted.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

Similar publications