A randomised control trial examining the effect of an antioxidant (Menevit) on pregnancy outcome during IVF-ICSI treatment.
BACKGROUND
Evidence has accumulated supporting the role of reactive oxygen species (ROS) in the pathogenesis of sperm dysfunction among men with infertility. Damage to sperm DNA by ROS can lead to failure of conception, miscarriage or potentially even childhood cancer. The objective of this study was to examine the effect of male antioxidant treatment on embryo quality and pregnancy outcome during in vitro fertilisation-intracytoplasmic sperm injection (IVF-ICSI) treatment.


METHODS
Sixty couples with severe male factor infertility were enrolled in a prospective randomised double-blind placebo-controlled trial. Male participants were randomly assigned to take either one capsule per day of the Menevit antioxidant or an identical in appearance placebo for three months prior to their partner's IVF cycle. The primary outcome was cleavage stage embryo quality and the secondary outcomes were oocyte fertilisation rate, pregnancy rates and treatment side-effects. Approval by the local Human Research Ethics Committee was obtained prior to the commencement of this study.


RESULTS
The antioxidant group recorded a statistically significant improvement in viable pregnancy rate (38.5% of transferred embryos resulting in a viable fetus at 13 weeks gestation) compared to the control group (16% viable pregnancy). No significant changes in oocyte fertilisation rate or embryo quality were detected between the antioxidant and the placebo groups. Side-effects on the Menevit antioxidant were rare (8%) and mild in nature.


CONCLUSIONS
The Menevit antioxidant appears to be a useful ancillary treatment that significantly improves pregnancy rates in couples undergoing IVF-ICSI treatment for severe male factor infertility.
Tremellen
Kelton
K
Repromed, Dulwich, SA 5065, Australia. kelton.tremellen@adelaide.edu.au
Miari
George
G
Froiland
David
D
Thompson
Jeremy
J
D000328:Adult; D000975:Antioxidants / Q000627:therapeutic use*; D000529:Complementary Therapies / Q000379:methods*; D019587:Dietary Supplements; D005260:Female; D006801:Humans; D007248:Infertility, Male / Q000188:drug therapy*; D008297:Male; D009845:Oligospermia / Q000188:drug therapy; D011247:Pregnancy; D018873:Pregnancy Rate; D017382:Reactive Oxygen Species; D020554:Sperm Injections, Intracytoplasmic / Q000187:drug effects* / Q000379:methods; D013081:Sperm Motility / Q000187:drug effects; D013094:Spermatozoa / Q000187:drug effects*; D016896:Treatment Outcome
D000975:Antioxidants; D017382:Reactive Oxygen Species