title: Efficacy of selenium and/or N-acetyl-cysteine for improving semen parameters in infertile men: a double-blind, placebo controlled, randomized study.
abstract: We explored the efficacy of selenium and/or or N-acetyl-cysteine for improving semen parameters in infertile men, and the associations among semen quality and the concentrations of selenium and N-acetyl-cysteine in seminal plasma.
  
  
  
  The study included 468 infertile men with idiopathic oligo-asthenoteratospermia who were randomized to receive 200 microg selenium orally daily (selenium group of 116), 600 mg N-acetyl-cysteine orally daily (N-acetyl-cysteine group of 118), 200 microg selenium plus 600 mg N-acetyl-cysteine orally daily (selenium plus N-acetyl-cysteine group of 116) or similar regimen of placebo (control group of 118) for 26 weeks, followed by a 30-week treatment-free period. These patients provided blood samples for the measurement of serum testosterone, estradiol, follicle-stimulating hormone, luteinizing hormone, prolactin, inhibin B, selenium and N-acetyl-cysteine. Semen samples were also obtained for routine semen analysis, and the measurement of seminal plasma selenium and N-acetyl-cysteine.
  
  
  
  In response to selenium and N-acetyl-cysteine treatment serum follicle-stimulating hormone decreased but serum testosterone and inhibin B increased. All semen parameters significantly improved with selenium and N-acetyl-cysteine treatment. Administering selenium plus N-acetyl-cysteine resulted in additive beneficial effects. A significant positive correlation existed between the seminal plasma concentrations of selenium and N-acetyl-cysteine, and semen parameters. A strong correlation was observed between the sum of the selenium and N-acetyl-cysteine concentrations, and mean sperm concentration (r = 0.67, p = 0.01), sperm motility (r = 0.64, p = 0.01) and percent normal morphology (r = 0.66, p = 0.01).
  
  
  
  These results indicate that supplemental selenium and N-acetyl-cysteine improve semen quality. We advocate their use for male infertility treatment.
authors.affiliation: Urology and Nephrology Research Center, Shahid Beheshti University, MC, Tehran, Islamic Republic of Iran. safarinejad@unrc.ir
authors.forename: Mohammad Reza
authors.initials: MR
authors.lastname: Safarinejad
authors.forename: Shiva
authors.initials: S
authors.lastname: Safarinejad
mesh_terms: D000111:Acetylcysteine / Q000008:administration & dosage*; D000284:Administration, Oral; D000328:Adult; D000704:Analysis of Variance; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005500:Follow-Up Studies; D006801:Humans; D007248:Infertility, Male / Q000097:blood* / Q000175:diagnosis / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011446:Prospective Studies; D012016:Reference Values; D018570:Risk Assessment; D012643:Selenium / Q000008:administration & dosage*; D055101:Semen Analysis; D013076:Sperm Count; D013081:Sperm Motility / Q000187:drug effects; D018709:Statistics, Nonparametric; D016896:Treatment Outcome
chemical_list: D012643:Selenium; D000111:Acetylcysteine