4. Swan et. al. – National Institute of environmental health
sciences
•Review of 61 published studies
•Data collected over 52 years (1938 to 1990)
•Decline in average sperm density in U.S. and other Western
countries
Average annual decrease of
U.S. 1.5 mio/ml = minus 1.5%/year
Europa minus 3.1%/year
DECREASE IN SPERM QUALITY
5. Semen quality and sperm
DNA damage
in relation to urinary
bisphenol A
among men
from an infertility clinic.
Bisphenol A
John D. Meekera et al. Reproductive Toxicology 2010
9. MALE SUBFERTILITY AND NUTRITION
Reduction of Sperm Quality
• No Disease?
• Defiency Syndrom?
Could therapy be Supplementation ?
10. LACK OF MICRONUTRITIENS IN FOOD
Guidelines on food fortification
with micronutrients
Lindsay Allen et al.
World Health Organization
2006
Male factor subfertility: possible causes and the
Impact of nutritional factors.
Wong WY et al.
Fertil Steril 2000 73:435-442
11. DECREASE IN SPERM QUALITY
Dietary intake of antioxidant nutrients is associated with
semen quality in young university students
Mínguez-Alarcón, Hum Reprod. 2012 Sep;27(9):2807-14
In this cross-sectional study, 215 young men
Our study suggests that some sperm parameters are sensitive
to dietary intake of antioxidant nutrients
12. EFFECT OF MICRONUTRITIENTS
Cochrane Database Syst Rev. 2011 Jan
19;1:CD007411.
Antioxidants for male subfertility.
Showell et al.
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….
16. Inclusion – criteria
Infertility for > 1 years
2 pathological spermiograms
Informed consent
Exclusion - criteria
Varicosis
Infection
Aspermia
Hormonal disorder
CONTROLLED STUDY – STUDY SETTING
17. Therapy Group 132 men, age Ø 34 a (18-43)
2 Capsules/day MICRONUTRITIENTS (PROFERTIL) for 3 month
Control Group 73 men, age Ø 38 a (22-52)
No TREATMENT / CHANGE OF LIFE STYLE
CONTROLLED STUDY – STUDY SETTING
18. 2 path spermiogr.
Questionare Questionare
Treatment group
Profertil 2 capsules
Control group
Change life style
Observation period
Telephone
Follow up
End of study
12 month
Inclusion
3 month
Study period
6 month
Follow up
25. EFFECT OF MICRONUTRITIENTS
Cochrane Database Syst Rev. 2011 Jan
19;1:CD007411.
Antioxidants for male subfertility.
Showell et al.
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….
26. Oxidative DNA damage impairs global sperm DNA
methylation in infertile men.
Tunc O, J Assist Reprod Genet. 2009 Sep-Oct;26(9-10)
CONCLUSIONS:
..... while antioxidant supplementation appears to have
the potential to reduce DNA damage and normalize sperm
DNA methylation.
EFFECT OF MICRONUTRITIENTS
27. Antioxidants and sperm DNA damage: a clinical
perspective.
Zini A, J Assist Reprod Genet. 2009 Aug;26(8):427-32.
RESULTS: . the data suggest that dietary antioxidants may
be beneficial in reducing sperm DNA damage, particularly,
in men with high levels of DNA fragmentation ...
EFFECT OF MICRONUTRITIENTS
28. Schuetz a
, H. Kurz a
, M. Imhof b
67 sub-fertile males (active treatment group)
40 Sub-fertile men receiving no active treatment served as
controls
Main outcome measure was change in sperm-hyaluronan
binding assay indicating DNA fragmentation index after 3
months.
SPERM DNA FRAGMENTATION INDEX DECREASES AFTER
MICRONUTRIENT SUPPLEMENTATION
29.
30. Micronutrients intake is associated with improved sperm
DNA quality in older men.
Schmid et al Fertil Steril 2012 Aug 23.
PATIENT(S): 22-80-year-old nonsmoking men (n = 80)
CONCLUSION(S): Men with higher dietary and supplement
intake of certain micronutrients may produce sperm with less
DNA damage, especially among older men.
DNA EFFECT OF MICRONUTRITIENTS
31. CONCLUSION
Sperm quality and male fertility is decreasing
Medical treatment of sperm quality unsuccessful
Decline of sperm quality may be a
defiency syndrome not a disease
32. CONCLUSION
Micronutritients are lacking in western countries
Change of life style may improve sperm quality
Micronutritients improve sperm quality in literature
Controlled prospective study prooves significant
improvement compared to control group
Micronutritients improve DNA sperm quality