Oumaima, G., Fadoua, B., Amira, D., Narjes, T., Arij, E., Henda, M., and Mounir, A.
The integrity of sperm DNA is vital for successful fertilization and genetic transmission to offspring. Yet, oxidative stress is a threat to this integrity. Our study aims to explore the effect of antioxidants on DNA integrity, and their implications for male fertility. The study was designed as a double blind, placebo controlled, clinical trial. From April 2020 to January 2023, a total of 263 partients with idiopathic infertility were selected and randomized into two groups: 131 participants received a combination of antioxidants, while 132 participants received a placebo. For each patient, we performed a TUNEL assay for sperm DNA fragmentation and an aniline blue staining for sperm chromatin decondensation initially prior to administering treatment, and then again after three months of treatment. The average age of patients was 38.94 ± 5.8 years. The two groups had comparable baseline characteristics. After 3 months of treatment, the DNA fragmentation index (DFI) decreased significantly within each group (p<0.001), but this variation was without significant difference between the two groups. An analysis of these results according to the initial DFI enabled us to define the cut-off point for significant improvement in sperm DNA fragmentation under treatment, at 20%. In fact, only patients with an initial fragmentation rate greater than or equal to 20% had a significant reduction in DFI after 3 months of antioxydant treatment. This significant difference was found respectively in the subgroup with initial DFI between 20 and 25% (p=0.002) and the subgroup with initial DFI >25% (p<=0.001). When comparing initial and final values of sperm chromatin decondensation rate, a decrease was found after 3 months of treatment only in the antioxidant group, with no statistically significant difference. Importantly, the rate of sperm chromatin decondensation increased after 3 months in the placebo group. On the other hand, no significant difference was found between the treatment and placebo groups after 3 months of treatment. In summary, our findings suggest that a three month antioxidant supplementation could reduce DNA fragmentation in patients with idiopathic infertility, but do not affect chromatin decondensation. Further investigation is necessary for optimizing therapeutic strategies to improve male fertility. [ABSTRACT FROM AUTHOR]