Docosahexaenoic acid in the treatment of male infertility caused by high sperm DNA fragmentation [Докозагексаеновая кислота в лечении мужского бесплодия, вызванного высоким уровнем фрагментации ДНК сперматозоидов]

Introduction. Antioxidant supplementation therapy continues to be the main treatment for male infertility associated with high level of sperm DNA damage. Docosahexaenoic acid (DHA) is one of the most promising components of antioxidant supplementation therapy. It also has anti-inflammatory properties that makes it interesting for treatment of patients with high level of sperm DNA damage and inflammation in male accessory glands. Materials and methods. One hundred and seventeen (117) infertile patients with high level of sperm DNA damage were recruited for this randomized, double blind, placebo-controlled study. Semen analysis, MAR-test, SCD test and sperm cryotolerance test were performed to all patients. Subjects were divided into 2 groups with high (>1 mln/ml) and low (<1 mln/ml) semen leucocyte concertation and then randomized into 2 subgroups of active treatment and 2 placebo subgroups. The active treatment subgroups received 1470 mg/day of DHA for 3 months. The placebo group received placebo for the same period. Laboratory tests were repeated after the treatment course had been finished. Results. Statistically significant increase in motility (42 % (25–61 %) vs 25 % (15–47 %), p <0.05), vitality (73 % (63–81 %) vs 41 % (35–64 %), p <0.05), decrease in sperm DNA fragmentation level (21 % (12–28 %) vs 33 % (25–39 %), p <0.05) and leucocyte concentration (1 million/ml (0.7–1.7 million/ml) vs 1,5 million/ml (1.1–2.1 million/ml), p <0.05) were observed in the subgroup with male accessory glands inflammation after treatment. Motility (15 % (8–19 %) vs 8 % (5–11 %), p <0.05) and vitality (37 % (25–46 %) vs 24 % (17–40 %), p <0.05) in this subgroup after a sperm cryotolerance test increased as well. In the subgroup with low semen leucocyte concertation statistically significant increase in motility (43 % (27–63 %) vs 34 % (21–54 %), p <0.05), vitality (77 % (66–85 %) vs 65 % (54.5–76.0 %), p <0.05) and decrease of sperm DNA fragmentation level (9 % (5.5–20.0 %) vs 25 % (18–33 %), p <0.05) were observed. DHA supplementation also resulted in statistically significant increase in motility (17 % (10–23 %) vs 6 % (5.0–10.5 %), p <0.05) and vitality (41 % (32.5–53.0 %) vs 37 % (30–49 %), p <0.05) after a sperm cryotolerance test in that subgroup. Conclusion. DHA supplementation therapy increases motility, vitality, sperm cryotolerance and decreases sperm DNA fragmentation regardless of the presence of an inflammatory process in male accessory glands. © 2020 Opuholi Zenskoj Reproduktivnoj Sistemy