Imperial College London
Alternate

Dr. Channa Jayasena MA PhD MRCP FRCPath

Faculty of Medicine, Department of Metabolism, Digestion and Reproduction

Reader in Reproductive Endocrinology
 
 
 
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Contact

 

c.jayasena Website

 
 
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Location

 

6N5CCommonwealth BuildingHammersmith Campus

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Summary

 

Publications

Citation

BibTex format

@article{Agarwal:2022:10.5534/wjmh.220067,
author = {Agarwal, A and Cannarella, R and Saleh, R and Harraz, AM and Kandil, H and Salvio, G and Boitrelle, F and Kuroda, S and Farkouh, A and Rambhatla, A and Zini, A and Colpi, G and Gul, M and Kavoussi, P and Hamoda, TA-AA-M and Ko, E and Calik, G and Toprak, T and Pinggera, G-M and Park, HJ and Abou, Ghayda R and Minhas, S and Busetto, GM and Bakircioglu, ME and Kadioglu, A and Chung, E and Russo, GI and Calogero, AE and Ambar, RF and Jayasena, CN and Shah, R},
doi = {10.5534/wjmh.220067},
journal = {The World Journal of Men's Health},
pages = {14--48},
title = {Impact of antioxidant therapy on natural pregnancy outcomes and semen parameters in infertile men: a systematic review and meta-analysis of randomized controlled trials},
url = {http://dx.doi.org/10.5534/wjmh.220067},
volume = {41},
year = {2022}
}
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TY  - JOUR
AB  - Purpose: Seminal oxidative stress (OS) is a recognized factor potentially associated with male infertility, but the efficacy ofantioxidant (AOX) therapy is controversial and there is no consensus on its utility. Primary outcomes of this study were to investigate the effect of AOX on spontaneous clinical pregnancy, live birth and miscarriage rates in male infertile patients. Secondary outcomes were conventional semen parameters, sperm DNA fragmentation (SDF) and seminal OS.Materials and Methods: Literature search was performed using Scopus, PubMed, Ovid, Embase, and Cochrane databases.Only randomized controlled trials (RCTs) were included and the meta-analysis was conducted according to PRISMA guidelines.Results: We assessed for eligibility 1,307 abstracts, and 45 RCTs were finally included, for a total of 4,332 infertile patients.We found a significantly higher pregnancy rate in patients treated with AOX compared to placebo-treated or untreated controls, without significant inter-study heterogeneity. No effects on live-birth or miscarriage rates were observed in four studies.A significantly higher sperm concentration, sperm progressive motility, sperm total motility, and normal sperm morphologywas found in patients compared to controls. We found no effect on SDF in analysis of three eligible studies. Seminal levels oftotal antioxidant capacity were significantly higher, while seminal malondialdehyde acid was significantly lower in patientsthan controls. These results did not change after exclusion of studies performed following varicocele repair.Conclusions: The present analysis upgrades the level of evidence favoring a recommendation for using AOX in male infertilityto improve the spontaneous pregnancy rate and the conventional sperm parameters. The failure to demonstrate an increasein live-birth rate, despite an increase in pregnancy rates, is due to the very few RCTs specifically assessing the impact of AOXon live-birth rate. Therefore, further RCTs assessing the
AU  - Agarwal,A
AU  - Cannarella,R
AU  - Saleh,R
AU  - Harraz,AM
AU  - Kandil,H
AU  - Salvio,G
AU  - Boitrelle,F
AU  - Kuroda,S
AU  - Farkouh,A
AU  - Rambhatla,A
AU  - Zini,A
AU  - Colpi,G
AU  - Gul,M
AU  - Kavoussi,P
AU  - Hamoda,TA-AA-M
AU  - Ko,E
AU  - Calik,G
AU  - Toprak,T
AU  - Pinggera,G-M
AU  - Park,HJ
AU  - Abou,Ghayda R
AU  - Minhas,S
AU  - Busetto,GM
AU  - Bakircioglu,ME
AU  - Kadioglu,A
AU  - Chung,E
AU  - Russo,GI
AU  - Calogero,AE
AU  - Ambar,RF
AU  - Jayasena,CN
AU  - Shah,R
DO  - 10.5534/wjmh.220067
EP  - 48
PY  - 2022///
SN  - 2287-4208
SP  - 14
TI  - Impact of antioxidant therapy on natural pregnancy outcomes and semen parameters in infertile men: a systematic review and meta-analysis of randomized controlled trials
T2  - The World Journal of Men's Health
UR  - http://dx.doi.org/10.5534/wjmh.220067
UR  - https://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000862145700001&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=a2bf6146997ec60c407a63945d4e92bb
UR  - https://wjmh.org/DOIx.php?id=10.5534/wjmh.220067
UR  - http://hdl.handle.net/10044/1/103962
VL  - 41
ER  -
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