新西蘭研究人員發(fā)現(xiàn),，男性服用維生素E和鋅等抗氧化劑或許能增強(qiáng)生育能力。
提觀點(diǎn)
新西蘭奧克蘭大學(xué)研究人員把研究對象鎖定為生育能力低的男性,，即生育能力低于平均水平但仍能生育,。
統(tǒng)計(jì)結(jié)果顯示，每20名男性中會有一人承受低生育能力困擾,，夫婦晚育一半源于男性生育能力低,。醫(yī)學(xué)專家認(rèn)為，男性生育能力低80%是因?yàn)榫邮艿窖趸?，?shù)量減少,，質(zhì)量降低。
精子氧化由一種名為自由基的分子引發(fā),。自由基是細(xì)胞新陳代謝產(chǎn)物,，具有強(qiáng)氧化性，可損傷機(jī)體組織和細(xì)胞功能,?？寡趸瘎┖心承┚S生素和營養(yǎng)成分，能夠幫助細(xì)胞抵御自由基損傷,。
一些學(xué)者設(shè)想,，男性服用抗氧化劑或許能夠幫助精子保持游動能力。研究人員回顧以往生殖研究,，希望獲得數(shù)據(jù),，支持這一觀點(diǎn)。
溯研究
研究人員回顧34項(xiàng)生育治療研究,，涉及近3000對夫婦,。治療方法包括體外受精和宮腔內(nèi)人工受精,，即兩種針對男性精子質(zhì)量低所致不孕癥的最常用方法。
分析15項(xiàng)研究中96個(gè)成功受孕案例,，研究人員發(fā)現(xiàn),，男性服用抗氧化劑后，生育能力增強(qiáng)4倍多,，配偶分娩活胎的可能性增加5倍,。
研究項(xiàng)目主管瑪麗安·肖維爾說：“口服抗氧化劑可能在一定程度上提高夫妻受孕幾率。”
研究報(bào)告由網(wǎng)上醫(yī)學(xué)電子雜志《科克倫圖書館》 The Cochrane Library 發(fā)表,。不過,，研究人員認(rèn)為，抗氧化劑增強(qiáng)男性生育能力的觀點(diǎn)并非絕對正確,，有待更多研究結(jié)果加以確認(rèn),。
遭質(zhì)疑
這項(xiàng)研究遭到一些生育專家質(zhì)疑。美國伊利諾伊大學(xué)泌尿?qū)W教授勞倫斯·羅斯說：“男性精子功能存在障礙,，不查明原因而單純借助抗氧化劑施行治療不合適,。”
另一些專家質(zhì)疑研究方法和研究對象數(shù)量。研究人員回顧的34項(xiàng)研究中,，沒有一項(xiàng)研究的參與人數(shù)超過1000人,，一些研究僅10人參與。
美國布朗大學(xué)教授馬克·西格曼說：“研究表明,，抗氧化劑能夠提高嬰兒安全出生可能性,，這一結(jié)論僅以20個(gè)案例為依據(jù)，樣本數(shù)量相對較少,。”他認(rèn)定,，研究涉及的抗氧化劑種類和數(shù)量不同，無法確定每一種抗氧化劑的效用,。
“一種治療方法對多數(shù)夫妻有效的想法不現(xiàn)實(shí),，”西格曼說，“雖然沒有證據(jù)表明抗氧化劑有害人體健康,，但我們不清楚哪一種抗氧化劑或者多少劑量能夠增強(qiáng)生育能力,，沒有一種抗氧化劑獲得（美國）食品和藥物管理局批準(zhǔn)用于不孕不育癥治療，消費(fèi)者不應(yīng)該偏聽偏信,。”（生物谷Bioon.com）
生物谷推薦原文出處：
Cochrane Database of Systematic Reviews 2011, Issue 1. Art. No.: CD007411. DOI: 10.1002/14651858.CD007411.pub2.
Antioxidants for male subfertility
Marian G Showell1, Julie Brown1, Anusch Yazdani2, Marcin T Stankiewicz3, Roger J Hart4
1Obstetrics and Gynaecology, University of Auckland, Auckland, New Zealand. 2Clinical Research and Development, Queensland Fertility Group, Woolloongabba, Australia. 3Reproductive Medicine, Flinders Reproductive Medicine, Bedford Park, Australia. 4School of Women's and Infants Health, The University of Western Australia, King Edward Memorial Hospital and Fertility Specialists of Western Australia, Subiaco, Australia
Abstract
Background
Between 30% to 80% of male subfertility cases are considered to be due to the damaging effects of oxidative stress on sperm. Oral supplementation with antioxidants may improve sperm quality by reducing oxidative stress.
Objectives
This Cochrane review aimed to evaluate the effect of oral supplementation with antioxidants for male partners of couples undergoing assisted reproduction techniques (ART).
Search strategy
We searched the Cochrane Menstrual Disorders and Subfertility Group Register, CENTRAL (The Cochrane Library), MEDLINE, EMBASE, CINAHL, PsycINFO and AMED databases (from their inception until Febuary 2010), trial registers, sources of unpublished literature, reference lists and we asked experts in the field.
Selection criteria
We included randomised controlled trials comparing any type or dose of antioxidant supplement (single or combined) taken by the male partner of a couple seeking fertility assistance with placebo, no treatment or another antioxidant. The outcomes were live birth, pregnancy, miscarriage, stillbirth, sperm DNA damage, sperm motility, sperm concentration and adverse effects.
Data collection and analysis
Two review authors independently assessed studies for inclusion and trial quality, and extracted data.
Main results
We included 34 trials with 2876 couples in total.
Live birth: three trials reported live birth. Men taking oral antioxidants had an associated statistically significant increase in live birth rate (pooled odds ratio (OR) 4.85, 95% CI 1.92 to 12.24; P = 0.0008, I2 = 0%) when compared with the men taking the control. This result was based on 20 live births from a total of 214 couples in only three studies.
Pregnancy rate: there were 96 pregnancies in 15 trials including 964 couples. Antioxidant use was associated with a statistically significant increased pregnancy rate compared to control (pooled OR 4.18, 95% CI 2.65 to 6.59; P < 0.00001, I2 = 0%).
Side effects: no studies reported evidence of harmful side effects of the antioxidant therapy used.
Authors' conclusions
The evidence suggests that antioxidant supplementation in subfertile males may improve the outcomes of live birth and pregnancy rate for subfertile couples undergoing ART cycles. Further head to head comparisons are necessary to identify the superiority of one antioxidant over another.
