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A Global Survey of Reproductive Specialists to Determine the Clinical Utility of Oxidative Stress Testing and Antioxidant Use in Male Infertility
A. Agarwal, R. Finelli, MKP. Selvam, K. Leisegang, A. Majzoub, N. Tadros, E. Ko, N. Parekh, R. Henkel, D. Durairajanayagam, GM. Colpi, CL. Cho, HN. Sallam, HJ. Park, R. Saleh, S. Micic, RF. Ambar, A. Zini, K. Tremellen, JG. Alvarez, A. Palani, M....
Language English Country Korea (South)
Document type Journal Article
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PubMed
33831977
DOI
10.5534/wjmh.210025
Knihovny.cz E-resources
- Publication type
- Journal Article MeSH
PURPOSE: The use of antioxidants is common practice in the management of infertile patients. However, there are no established guidelines by professional societies on antioxidant use for male infertility. MATERIALS AND METHODS: Using an online survey, this study aimed to evaluate the practice pattern of reproductive specialists to determine the clinical utility of oxidative stress (OS) testing and antioxidant prescriptions to treat male infertility. RESULTS: Responses from 1,327 participants representing 6 continents, showed the largest participant representation being from Asia (46.8%). The majority of participants were attending physicians (59.6%), with 61.3% having more than 10 years of experience in the field of male infertility. Approximately two-thirds of clinicians (65.7%) participated in this survey did not order any diagnostic tests for OS. Sperm DNA fragmentation was the most common infertility test beyond a semen analysis that was prescribed to study oxidative stress-related dysfunctions (53.4%). OS was mainly tested in the presence of lifestyle risk factors (24.6%) or sperm abnormalities (16.3%). Interestingly, antioxidants were prescribed by 85.6% of clinicians, for a duration of 3 (43.7%) or 3-6 months (38.6%). A large variety of antioxidants and dietary supplements were prescribed, and scientific evidence were mostly considered to be modest to support their clinical use. Results were not influenced by the physician's age, geographic origin, experience or training in male infertility. CONCLUSIONS: This study is the largest online survey performed to date on this topic and demonstrates 1) a worldwide understanding of the importance of this therapeutic option, and 2) a widely prevalent use of antioxidants to treat male infertility. Finally, the necessity of evidence-based clinical practice guidelines from professional societies is highlighted.
Alexandria University Faculty of Medicine Alexandria Egypt
American Center for Reproductive Medicine Cleveland Clinic Ohio USA
American College of Embryology Houston TX USA
ANDROFERT Andrology and Human Reproduction Clinic Campinas Brazil
Andrology and IVF Unit Procrea Institute Lugano Switzerland
Andrology Centre Department of Urology Semmelweis University Budapest Hungary
Andrology Group at Ideia Fertil Institute of Human Reproduction Santo Andre Brazil
Andrology Unit Instituto De Ginecologia y Fertilidad Buenos Aires Argentina
ANDROS Day Surgery Clinic Reproductive Medicine Unit Palermo Italy
Anfa Fertility Center Casablanca Morocco
Austin Fertility and Reproductive Medicine Westlake IVF Austin TX USA
Avant Concierge Urology and University of Central Florida Winter Garden FL USA
Biasa Fertility Clinic Lomè Togo
Cabinet D'Andrologie Victor Hugo American Hospital of Paris Reproductive Center Paris France
Centro ANDROGEN La Coruro Spain
Citmer Reproductive Medicine IVF LAB Mexico City Mexico
Deparment of Andrology Fundacio Puigvert Barcelona Spain
Department of Andrology and Reproductive Medicine Jindal Hospital Meerut India
Department of Andrology Hammersmith Hospital London UK
Department of Andrology Sexology and STIs Faculty of Medicine Cairo University Cairo Egypt
Department of Biochemistry College of Medicine University of Garmian Kalar Iraq
Department of Dermatology Venereology and Andrology Faculty of Medicine Sohag University Sohag Egypt
Department of Medical Bioscience University of the Western Cape Bellville South Africa
Department of Metabolism Digestion and Reproduction Imperial College London London UK
Department of Obstetrics and Gynaecology University College Hospital Ibadan Nigeria
Department of Obstetrics and Gynecology Bahcesehir University Istanbul Turkey
Department of Obstetrics and Gynecology Bukovinian State Medical University Chernivtsi Ukraine
Department of Obstetrics and Gynecology University of Nicosia Medical School Nicosia Cyprus
Department of Surgery McGill University St Mary's Hospital Montreal QC Canada
Department of Urology Cleveland Clinic Cleveland OH USA
Department of Urology Hamad Medical Corporation Doha Qatar
Department of Urology Lilavati Hospital and Research Centre Mumbai India
Department of Urology Loma Linda University Health Loma Linda CA USA
Department of Urology Military Medical Academy Belgrade Serbia
Department of Urology Pusan National University School of Medicine Busan Korea
Department of Urology Tulane University Health Sciences Center New Orleans LA USA
Department of Urology University of Ankara Ankara Turkey
Department of Urology University of Queensland Brisbane Australia
Department of Urology University of Santo Tomas Hospital Manila Philippines
Division of Urology Department of Surgery University of Campinas Campinas Brazil
Division of Urology Southern Illinois University School of Medicine Springfield IL USA
Faculty of Medicine Universiti Teknologi MARA Sungai Buloh Campus Selangor Malaysia
Fertility Medical Group Sapientiae Institute São Paulo Brazil
Fertimed Ltd Olomouc Czech Republic
Hamad Medical Corporation Doha Qatar
Honorary Staff of Cooper University Hospital Camden NJ USA
Instituto Ideia Fertil Human Reproduction Centre Faculdade de Medicina do ABC Sao Paulo Brazil
International Centre for Reproductive Medicine Saint Petersburg Russia
IVF Japan Group HORAC Grand Front Osaka Clinic Osaka Japan
IVF Unit Al Boustane Clinic Rabat Morocco
Medical Research Institute of Pusan National University Hospital Busan Korea
Middle East Fertility Society Canadian Foundation for Reproductive Medicine Lebanon
Odyssèe Clinic for Assisted Reproduction Douala Cameroun
Reproductive Medicine Unit New Jahra Hospital Ministry of Health Al Jahra Kuwait
RMU Dr Arab Medical Center Jeddah Saudi Arabia
S H Ho Urology Centre Department of Surgery The Chinese University of Hong Kong Hong Kong
School of Natural Medicine University of the Western Cape South Africa
Section of Andrology Istanbul Faculty of Medicine Istanbul Turkey
St Barbara Clinic Bad Vigaun Austria
Tiziri IVF Center Algeriers Algeria
Urology VUK Center Belgrade Serbia
Uromedica Polyclinic Andrology Department Belgrade Serbia
References provided by Crossref.org
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- $a A Global Survey of Reproductive Specialists to Determine the Clinical Utility of Oxidative Stress Testing and Antioxidant Use in Male Infertility / $c A. Agarwal, R. Finelli, MKP. Selvam, K. Leisegang, A. Majzoub, N. Tadros, E. Ko, N. Parekh, R. Henkel, D. Durairajanayagam, GM. Colpi, CL. Cho, HN. Sallam, HJ. Park, R. Saleh, S. Micic, RF. Ambar, A. Zini, K. Tremellen, JG. Alvarez, A. Palani, M. Arafa, MM. Gava, S. Jindal, E. Amar, Z. Kopa, MR. Moein, GM. Busetto, P. Sengupta, P. Kavoussi, I. Maldonado, J. Fikri, E. Borges, M. Martinez, D. Bojovic, O. Rajmil, K. Aydos, S. Parekattil, JL. Marmar, O. Sefrioui, A. Jungwirth, MGR. Peña, EB. Cordts, H. Elbardisi, T. Mostafa, M. Sabbaghian, MA. Sadighi Gilani, Y. Morimoto, MG. Alves, A. Spasic, U. Kenic, J. Ramsay, EO. Akande, A. Oumeziane, D. Dozortsev, E. Chung, EG. Bell, A. Allegra, V. Tanos, M. Fiadjoe, T. Gurgan, M. Abou-Abdallah, H. Al-Rumaih, I. Oborna, H. Arab, S. Esteves, M. Amer, A. Kadioglu, O. Yuzko, V. Korsak, R. Shah
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- $a PURPOSE: The use of antioxidants is common practice in the management of infertile patients. However, there are no established guidelines by professional societies on antioxidant use for male infertility. MATERIALS AND METHODS: Using an online survey, this study aimed to evaluate the practice pattern of reproductive specialists to determine the clinical utility of oxidative stress (OS) testing and antioxidant prescriptions to treat male infertility. RESULTS: Responses from 1,327 participants representing 6 continents, showed the largest participant representation being from Asia (46.8%). The majority of participants were attending physicians (59.6%), with 61.3% having more than 10 years of experience in the field of male infertility. Approximately two-thirds of clinicians (65.7%) participated in this survey did not order any diagnostic tests for OS. Sperm DNA fragmentation was the most common infertility test beyond a semen analysis that was prescribed to study oxidative stress-related dysfunctions (53.4%). OS was mainly tested in the presence of lifestyle risk factors (24.6%) or sperm abnormalities (16.3%). Interestingly, antioxidants were prescribed by 85.6% of clinicians, for a duration of 3 (43.7%) or 3-6 months (38.6%). A large variety of antioxidants and dietary supplements were prescribed, and scientific evidence were mostly considered to be modest to support their clinical use. Results were not influenced by the physician's age, geographic origin, experience or training in male infertility. CONCLUSIONS: This study is the largest online survey performed to date on this topic and demonstrates 1) a worldwide understanding of the importance of this therapeutic option, and 2) a widely prevalent use of antioxidants to treat male infertility. Finally, the necessity of evidence-based clinical practice guidelines from professional societies is highlighted.
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