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The relationship of plasma antioxidant levels to semen parameters: the Males, Antioxidants, and Infertility (MOXI) randomized clinical trial

  • Reproductive Physiology and Disease
  • Published:
Journal of Assisted Reproduction and Genetics Aims and scope Submit manuscript

Abstract

Purpose

The understanding of the role of plasma antioxidant levels in male fertility in the USA is limited. In a secondary analysis of the Males, Antioxidants, and Infertility (MOXI) randomized clinical trial, we sought to determine whether serum levels of vitamin E (α-tocopherol), zinc, and selenium were correlated with semen parameters and couple fertility outcomes.

Methods

This study is a secondary analysis of the MOXI clinical trial. The primary endpoints in this secondary analysis include semen parameters, and DNA fragmentation and clinical outcomes including pregnancy and live birth. Analyses were completed using Wilcoxon’s rank-sum test and linear regression models.

Results

At baseline, the analysis included plasma labs for vitamin E (n = 131), selenium (n = 124), and zinc (n = 128). All baseline plasma values were in the normal ranges. There was no association between selenium, zinc, or vitamin E levels and semen parameters or DNA fragmentation. Baseline antioxidant levels in the male partners did not predict pregnancy or live birth among all couples. Among those randomized to placebo, baseline male antioxidant levels did not differ between those couples with live birth and those that did not conceive or have a live birth.

Conclusions

Among men attending fertility centers in the USA, who have sufficient plasma antioxidant levels of zinc, selenium, or vitamin E, no association was observed between vitamins and semen parameters or clinical outcomes in couples with male infertility. Higher levels of antioxidants among men with circulating antioxidants in the normal range do not appear to confer benefit on semen parameters or male fertility.

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Acknowledgements

The guidance of Dr. Esther Eisenberg is greatly acknowledged, as is the valuable contribution of each and every MOXI study participant.

Funding

This project was supported by the Eunice Kennedy Shriver National Institute for Children Health and Development, National Institutes of Health, through Grant K23 HD097307 (JFK) and the CREST Program R25 HD075737 (to NFS). This work was supported by National Institutes of Health (NIH)/Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Grants U10HD077844 (to A.Z.S), U10HD077680 (to K.R.H, V.L.B), 1U10 HD077841 (to MIC), U10HD027049 (to C.C); U10HD038992 (to R.S.L); U10HD039005 (to M.P.D, R.U., S.K.); and U10HD055925 (to H.Z.).

Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, University of Texas Health Science Center San Antonio, San Antonio, Texas; and Aspire Fertility, San Antonio, TX, USA

    Jennifer F. Knudtson

  2. Department of Biostatistics, Yale School of Public Health, New Haven, CT, USA

    Fangbai Sun & Heping Zhang

  3. Department of Urology, University of North Carolina, Chapel Hill, NC, USA

    R. Matthew Coward

  4. Department of Obstetrics and Gynecology, Health Sciences Center, University of Oklahoma, Oklahoma City, OK, USA

    Karl R. Hansen

  5. Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, PA, USA

    Kurt T. Barnhart

  6. Department of Urology, University of California- San Francisco, San Francisco, CA, USA

    James Smith

  7. Department of Obstetrics and Gynecology, Pennsylvania State University, Hershey, PA, USA

    Richard S. Legro

  8. Department of Obstetrics and Gynecology, Medical College of Georgia, Augusta University, Augusta, GA, USA

    Michael P. Diamond

  9. Department of Obstetrics and Gynecology & Molecular Medicine and Genetics, Wayne State University, Detroit, MI, USA

    Stephen A. Krawetz

  10. Department of Reproductive Endocrinology and Infertility, Atrium Health, Charlotte, NC, USA

    Rebecca Usadi

  11. Department of Gynecology and Obstetrics, Division of Reproductive Endocrinology and Infertility, Johns Hopkins University, Lutherville, MD, USA

    Valerie L. Baker

  12. Department of Obstetrics and Gynecology, University of Colorado School of Medicine, Aurora, CO, USA

    Nanette Santoro

  13. Department of Reproductive Endocrinology and Infertility, Duke University School of Medicine, Durham, NC, USA

    Anne Z. Steiner

Authors
  1. Jennifer F. Knudtson
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  2. Fangbai Sun
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  3. R. Matthew Coward
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  4. Karl R. Hansen
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  5. Kurt T. Barnhart
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  6. James Smith
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  7. Richard S. Legro
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  8. Michael P. Diamond
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  9. Stephen A. Krawetz
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  10. Heping Zhang
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  11. Rebecca Usadi
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  12. Valerie L. Baker
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  13. Nanette Santoro
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  14. Anne Z. Steiner
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Contributions

Study design: All authors.

Statistical analysis: JK, AS, FS.

Data analysis: FS, JK, AS.

Manuscript: All authors.

Corresponding author

Correspondence to Jennifer F. Knudtson.

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Conflict of interest

Dr. Diamond reports other support from Advanced Reproductive Care, LLC outside the submitted work. Dr. Steiner reports support from Prima-Temp outside the submitted work.

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Knudtson, J.F., Sun, F., Coward, R.M. et al. The relationship of plasma antioxidant levels to semen parameters: the Males, Antioxidants, and Infertility (MOXI) randomized clinical trial. J Assist Reprod Genet 38, 3005–3013 (2021). https://doi.org/10.1007/s10815-021-02301-2

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  • DOI: https://doi.org/10.1007/s10815-021-02301-2

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