The World Journal of Men's Health (Jul 2021)
A Global Survey of Reproductive Specialists to Determine the Clinical Utility of Oxidative Stress Testing and Antioxidant Use in Male Infertility
- Ashok Agarwal,
- Renata Finelli,
- Manesh Kumar Panner Selvam,
- Kristian Leisegang,
- Ahmad Majzoub,
- Nicholas Tadros,
- Edmund Ko,
- Neel Parekh,
- Ralf Henkel,
- Damayanthi Durairajanayagam,
- Giovanni M. Colpi,
- Chak-Lam Cho,
- Hassan N. Sallam,
- Hyun Jun Park,
- Ramadan Saleh,
- Sava Micic,
- Rafael F. Ambar,
- Armand Zini,
- Kelton Tremellen,
- Juan G. Alvarez,
- Ayad Palani,
- Mohamed Arafa,
- Marcello M. Gava,
- Sunil Jindal,
- Edouard Amar,
- Zsolt Kopa,
- Mohammad-Reza Moein,
- Gian Maria Busetto,
- Pallav Sengupta,
- Parviz Kavoussi,
- Israel Maldonado,
- Jamal Fikri,
- Edson Borges Jr.,
- Marlon Martinez,
- Djordje Bojovic,
- Osvaldo Rajmil,
- Kaan Aydos,
- Sijo Parekattil,
- Joel L. Marmar,
- Omar Sefrioui,
- Andreas Jungwirth,
- Marcelo Gabriel Rodriguez Peña,
- Emerson B. Cordts,
- Haitham Elbardisi,
- Taymour Mostafa,
- Marjan Sabbaghian,
- Mohammad Ali Sadighi Gilani,
- Yoshiharu Morimoto,
- Marco G. Alves,
- Aleksandra Spasic,
- Uros Kenic,
- Jonathan Ramsay,
- Ebenezer Oluwole Akande,
- Amina Oumeziane,
- Dmitri Dozortsev,
- Eric Chung,
- Ernestine Gwet Bell,
- Adolfo Allegra,
- Vasilios Tanos,
- Moïse Fiadjoe,
- Timur Gurgan,
- Michel Abou-Abdallah,
- Hazem Al-Rumaih,
- Ivana Oborna,
- Hesham Arab,
- Sandro Esteves,
- Medhat Amer,
- Ates Kadioglu,
- Oleksandr Yuzko,
- Vladislav Korsak,
- Rupin Shah
Affiliations
- Ashok Agarwal
- ORCiD
- Cleveland Clinic, Cleveland, OH, USA
- Renata Finelli
- ORCiD
- Cleveland Clinic, Cleveland, OH, USA
- Manesh Kumar Panner Selvam
- ORCiD
- Cleveland Clinic, Cleveland, OH, USA
- Kristian Leisegang
- ORCiD
- University of the Western Cape, South Africa
- Ahmad Majzoub
- ORCiD
- Hamad Medical Corporation, Doha, Qatar
- Nicholas Tadros
- ORCiD
- Southern Illinois University School of Medicine, Springfield, IL
- Edmund Ko
- ORCiD
- Loma Linda University Health, Loma Linda, CA
- Neel Parekh
- ORCiD
- Cleveland Clinic, Cleveland, OH, USA
- Ralf Henkel
- ORCiD
- Cleveland Clinic, Cleveland, OH, USA
- Damayanthi Durairajanayagam
- ORCiD
- Universiti Teknologi MARA, Sungai Buloh Campus, Selangor, Malaysia
- Giovanni M. Colpi
- ORCiD
- Andrology and IVF Unit, Procrea Institute, Lugano, Switzerland
- Chak-Lam Cho
- ORCiD
- The Chinese University of Hong Kong, Hong Kong
- Hassan N. Sallam
- ORCiD
- Alexandria University Faculty of Medicine, Alexandria, Egypt
- Hyun Jun Park
- ORCiD
- Department of Urology, Pusan National University School of Medicine, Busan, Korea
- Ramadan Saleh
- ORCiD
- Sohag University, Sohag, Egypt
- Sava Micic
- ORCiD
- Uromedica Polyclinic, Andrology Department, Belgrade, Serbia
- Rafael F. Ambar
- ORCiD
- Faculdade de Medicina do ABC, Santo André, Brazil
- Armand Zini
- ORCiD
- McGill University, St. Mary’s Hospital, Montreal, QC, Canada
- Kelton Tremellen
- ORCiD
- Flinders University, Bedford Park, South Australia
- Juan G. Alvarez
- ORCiD
- Centro ANDROGEN, La Coruro, Spain
- Ayad Palani
- ORCiD
- University of Garmian, Kalar, Iraq
- Mohamed Arafa
- ORCiD
- Cleveland Clinic, Cleveland, OH, USA
- Marcello M. Gava
- ORCiD
- Faculdade de Medicina do ABC, Santo André, Brazil
- Sunil Jindal
- ORCiD
- Jindal Hospital, Meerut, India
- Edouard Amar
- ORCiD
- American Hospital of Paris Reproductive Center, Paris, France
- Zsolt Kopa
- ORCiD
- Semmelweis University, Budapest, Hungary
- Mohammad-Reza Moein
- ORCiD
- Yazd Research and Clinical Center for Infertility, Yazd, Iran
- Gian Maria Busetto
- ORCiD
- University of Foggia Policlinico Riuniti of Foggia, Foggia, Italy
- Pallav Sengupta
- ORCiD
- MAHSA University, Kuala Lumpur, Malaysia
- Parviz Kavoussi
- ORCiD
- Austin Fertility & Reproductive Medicine/Westlake IVF, Austin, TX
- Israel Maldonado
- ORCiD
- Citmer Reproductive Medicine, IVF LAB, Mexico City, Mexico,
- Jamal Fikri
- ORCiD
- IVF Unit, Al Boustane Clinic, Rabat, Morocco
- Edson Borges Jr.
- ORCiD
- Fertility Medical Group, Sapientiae Institute, São Paulo, Brazil
- Marlon Martinez
- ORCiD
- University of Santo Tomas Hospital, Manila, Philippines
- Djordje Bojovic
- ORCiD
- GAO Bojović, Belgrade, Serbia
- Osvaldo Rajmil
- ORCiD
- Fundacio Puigvert, Barcelona, Spain
- Kaan Aydos
- ORCiD
- University of Ankara, Ankara, Turkey
- Sijo Parekattil
- ORCiD
- Avant Concierge Urology & University of Central Florida, Winter Garden, FL
- Joel L. Marmar
- ORCiD
- Honorary Staff of Cooper University Hospital, Camden, NJ
- Omar Sefrioui
- ORCiD
- Anfa Fertility Center, Casablanca, Morocco
- Andreas Jungwirth
- ORCiD
- St. Barbara Clinic, Bad Vigaun, Austria
- Marcelo Gabriel Rodriguez Peña
- ORCiD
- Andrology Unit, Instituto De Ginecologia y Fertilidad (IFER), Buenos Aires, Argentina
- Emerson B. Cordts
- ORCiD
- Instituto Ideia Fertil-Human Reproduction Centre-Faculdade de Medicina do ABC, Sao Paulo, Brazil
- Haitham Elbardisi
- ORCiD
- Hamad Medical Corporation, Doha, Qatar
- Taymour Mostafa
- ORCiD
- Cairo University, Cairo, Egypt
- Marjan Sabbaghian
- ORCiD
- Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
- Mohammad Ali Sadighi Gilani
- ORCiD
- Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
- Yoshiharu Morimoto
- ORCiD
- IVF Japan Group, HORAC Grand Front Osaka Clinic, Osaka, Japan
- Marco G. Alves
- ORCiD
- University of Porto, Porto, Portugal
- Aleksandra Spasic
- ORCiD
- Military Medical Academy, Belgrade, Serbia
- Uros Kenic
- ORCiD
- Urology VUK Center, Belgrade, Serbia,
- Jonathan Ramsay
- ORCiD
- Hammersmith Hospital, London, UK
- Ebenezer Oluwole Akande
- ORCiD
- University College Hospital, Ibadan, Nigeria
- Amina Oumeziane
- ORCiD
- Tiziri IVF Center, Algeriers, Algeria
- Dmitri Dozortsev
- ORCiD
- American College of Embryology, Houston, TX
- Eric Chung
- ORCiD
- University of Queensland, Brisbane, Australia
- Ernestine Gwet Bell
- ORCiD
- Odyssèe Clinic for Assisted Reproduction, Douala, Cameroun
- Adolfo Allegra
- ORCiD
- ANDROS Day Surgery Clinic, Reproductive Medicine Unit, Palermo, Italy
- Vasilios Tanos
- ORCiD
- University of Nicosia Medical School, Nicosia, Cyprus
- Moïse Fiadjoe
- ORCiD
- Biasa Fertility Clinic, Lomè, Togo
- Timur Gurgan
- ORCiD
- Bahcesehir University, Istanbul, Turkey
- Michel Abou-Abdallah
- ORCiD
- Canadian Foundation for Reproductive Medicine, Lebanon
- Hazem Al-Rumaih
- ORCiD
- New Jahra Hospital, Ministry of Health, Al Jahra, Kuwait
- Ivana Oborna
- ORCiD
- Fertimed Ltd., Olomouc, Czech Republic
- Hesham Arab
- ORCiD
- RMU Dr. Arab Medical Center, Jeddah, Saudi Arabia
- Sandro Esteves
- ORCiD
- ANDROFERT, Andrology & Human Reproduction Clinic, Campinas, Brazil
- Medhat Amer
- ORCiD
- Sexology & STIs, Faculty of Medicine, Cairo University, Cairo, Egypt
- Ates Kadioglu
- ORCiD
- Istanbul Faculty of Medicine, Istanbul, Turkey
- Oleksandr Yuzko
- ORCiD
- Bukovinian State Medical University, Chernivtsi, Ukraine
- Vladislav Korsak
- ORCiD
- International Centre for Reproductive Medicine, Saint-Petersburg, Russia
- Rupin Shah
- ORCiD
- Department of Urology, Lilavati Hospital and Research Centre, Mumbai, India
- DOI
- https://doi.org/10.5534/wjmh.210025
- Journal volume & issue
-
Vol. 39,
no. 3
pp. 470 – 488
Abstract
Purpose: The use of antioxidants is common practice in the management of infertile patients. However, there are no estab-lished guidelines by professional societies on antioxidant use for male infertility. Materials and Materials and Methods: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: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?? 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?셲 age, geographic origin, experience or training in male infertility. Conclusions:Conclusions: This study is the largest online survey performed to date on this topic and demonstrates 1) a worldwide under-standing 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.
Keywords