Probiotics Outperform Antioxidants in Improving Semen Parameters of Men with Idiopathic Oligoasthenoteratozoospermia: A Randomized Controlled Trial

TL;DR

This study found that probiotics improved sperm quality more effectively than antioxidants in men with a common type of infertility.

Contribution

First direct comparison of probiotics and antioxidants for treating idiopathic oligoasthenoteratozoospermia.

Findings

Probiotics significantly improved sperm concentration, motility, and morphology compared to placebo.

Probiotics outperformed antioxidants in improving sperm motility and morphology.

No significant effect was observed on semen volume in any group.

Abstract

Idiopathic oligoasthenoteratozoospermia (iOAT) treatment still poses significant challenges. This study aims to compare the therapeutic efficacy of probiotics on sperm parameters of iOAT patients with placebo and antioxidants.

In this triple-blind, randomized controlled trial, 110 men with iOAT were assigned to receive either a probiotic (Familact®), an antioxidant (Sperigen®), or a placebo daily for 3 months, in two academic centers in Iran (Isfahan and Yazd). The study was conducted from July 2021 to April 2022. Sperm parameters were analyzed using computer-assisted semen analysis. The main measured outcomes included semen volume and sperm features, including motility, morphology, and concentration. Changes in semen parameters were assessed using linear mixed-effects models with fixed effects for time, group, and their interaction. Estimated marginal means were compared across groups using Bonferroni-adjusted pairwise tests.

Overall, 110 men (mean age of 34.3±4.5 years) were included in the final analysis. Significant Time×Group interactions were found for sperm concentration (P=0.003), motility (P<0.001),
and morphology (P<0.001), but not for semen volume (P=0.71). After 3 months, the probiotic group showed significantly greater improvements in sperm concentration (10.42±1.11×106/mL, P=0.007),
motility (46.65±3.73%, P=0.001), and morphology (4.31±0.21%, P<0.001) compared to the placebo group. Additionally, probiotics outperformed antioxidants in morphology (P<0.001) and motility (P=0.009).

This study is the first to directly compare probiotics and antioxidants in treating iOAT. Probiotics showed superior performance in sperm motility and morphology compared to antioxidants, although drawing a strong conclusion requires further robust studies

Trial Registration Number: IRCT20150420021869N5.

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