Role of male factor in early recurrent embryo loss: do antioxidants have any effect?

Objective: To evaluate whether increasing antioxidant intake in men with high levels of DNA damage or lipid peroxidation improves gestational results in couples with history of recurrent embryo loss. Design: Descriptive study (case series). Setting: Early recurrent embryo loss program at the University of Antioquia, Medellin, Colombia. Patient(s): Seventeen men whose spouses had a history of two or more embryo losses before 12 weeks of gestation. Intervention(s): Male partners with increased DNA fragmentation index (%DFI) or high thiobarbituric acid reactive substances (TBARS) were instructed to consume a diet rich in antioxidants or commercial multivitamins containing beta-carotene, vitamin C, vitamin E, and zinc for at least 3 months. Main Outcome Measure(s): Pregnancy outcome was recorded in the spouses of men with increased %DFI or TBARS who received antioxidant supplementation. Results: Of the 17 men, 9 (53%) presented with an increased %DFI or TBARS. They were started on an antioxidant supplementation regimen. Of these nine men, six of their spouses became pregnant. All couples whose male partners accepted antioxidant supplementation achieved a successful pregnancy. Conclusions: Our study demonstrates the benefits of an increased intake of antioxidant-rich food or antioxidant supplements by men who show high levels of sperm DNA fragmentation or lipid peroxidation, which could result in an improvement in gestational outcomes in couples with history of recurrent embryo losses. (Fertil Steril (R) 2009;92:565-71. (C) 2009 by American Society for Reproductive Medicine.)