Male Infertility

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WHAT CAUSES MALE INFERTILITY?

Male infertility can be due to multiple reasons including varicocele (enlargement of spermatic veins), testicular failure, hormone dysfunction, genital tract infection or exposure to toxins, but in almost a third of cases, the cause is unknown.20
Infertility of which the cause is unknown or unexplained, is called idiopathic infertility. Oxidative stress (OS) is believed to be an important cause of idiopathic male infertility. Oxidative stress is a condition where the body’s natural antioxidant defence mechanisms are overwhelmed by harmful free radicals, also known as reactive oxygen species (ROS).18
30 % – 40 % of infertile men have elevated levels of harmful reactive oxygen species (ROS) in their seminal plasma.18
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DO YOU SUFFER FROM…

  • Infertility
  • Poor sperm quality
  • Imbalanced testosterone levels
  • Insulin resistance
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DO YOU SUFFER FROM MALE INFERTILITY?

Infertility is defined as the inability to achieve pregnancy within 12 months or more of regular unprotected sexual intercourse17

 

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IMPORTANT FACTORS DETERMINING MALE FERTILITY

A semen analysis is often one of the first tests performed to help establish if a man has infertility issues. A semen analysis measures, among other things, the number and quality of sperm in the semen sample.19
QUANTITY
Too little sperm in an ejaculation might make it more difficult to get pregnant.19
MOVEMENT
Known as motility. A man is most likely to be fertile if at least 50% of his sperm are moving.19
STRUCTURE
Known as morphology. Normal sperm have oval heads and long tails, which work together to propel them. The more sperm a man has with a normal shape and structure, the more likely he is to be fertile.19

 

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WHAT CAUSES MALE INFERTILITY?

The changes in sperm quality and quantity (i.e. male infertility) can be due to multiple reasons including varicocele (enlargement of spermatic veins), testicular failure, hormone dysfunction, genital tract infection or exposure to toxins, but in almost a third of cases, the cause is unknown.20
Infertility of which the cause is unknown or unexplained, is called idiopathic infertility. In some cases, oxidative stress (OS) may be suspected as a contributing factor, but definitive evidence linking it to infertility may not always be clear. Oxidative stress is a condition where the body’s natural antioxidant defence mechanisms are overwhelmed by harmful free radicals, also known as reactive oxygen species (ROS).18
30 % – 40 % of infertile men have elevated levels of harmful reactive oxygen species (ROS) in their seminal plasma.18

 

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WHAT IS OXIDATIVE STRESS?

It is ironic that oxygen, an element that is essential for life, under certain situations has detrimental effects on the human body.21
During normal metabolism, a small percentage of oxygen get changed into reactive oxygen species (ROS) which are free radicals.  A free radical is a molecule which has been reduced (i.e. lost an electron) and is thus unstable. They are destructive because they are like bullies that beat up on other cells and steal their vital electrons.21
Electrons come in pairs, so free radicals try to stabilise themselves by stealing an electron from another oxygen molecule.21

 

 

Oxidative stress is an imbalance between the systemic manifestation of ROS and the body’s ability to detoxify and to repair resulting damage.18,22
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WHAT CAUSES OXIDATIVE STRESS?

Oxidative stress may be caused by internal (within the body) or external (outside the body) factors, both of which may have a negative impact on male and female reproductive health.4,16,18,23
Antioxidant supplementation has been shown to help restore balance and improve fertility success rates.2,4,15,16
Antioxidant supplementation in males has been shown to improve sperm concentration, motility (movement) and morphology (size, shape and structure). In women, antioxidant supplementation is associated with better egg cell quality during assisted reproductive techniques such as IVF.6,24

 

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WHAT IS SINOPOL® HIM?

Sinopol® him is a supplement which contains alpha-lipoic acid, myo-inositol, coenzyme Q10, zinc, selenium and vitamins B2, B6 and B12. These ingredients work together to support male reproductive health by decreasing oxidative stress, improving sperm quality, rebalancing testosterone levels and decreasing insulin resistance.12,15,16,25

 

 

Alpha-lipoic acid

Alpha-lipoic acid is a powerful antioxidant which is also able to regenerate other antioxidants (Vitamin C and E).11,26 It helps to reduce insulin resistance, body weight and abdominal circumference.11,12,25

Myo-inositol

Myo-inositol has a possible role as antioxidant agent and supports the rebalancing of  hormones. It plays a role in insulin metabolism and also helps to improve sperm movement and concentration.16,27-29

Coenzyme Q10

Coenzyme Q10 is another antioxidant which helps to improve sperm concentration and sperm movement, as well as helps to improve the amount of normal looking sperm.30-33

Zinc

As an antioxidant, zinc plays a role to support normal sperm development. It contributes to normal testosterone levels in the blood and supports reproductive function. It has also been shown to help increase sperm count and movement, as well as the amount of normal looking sperm.15,34,35

Selenium

Selenium supports normal sperm development and helps to protect sperm from oxidative stress. It has also been shown to help increase sperm count and movement, as well as the amount of normal looking sperm.15,29,36

Vitamins B2, B6 and B12

These vitamins contribute to the protection of cells from oxidative stress and help to regulate hormonal activity.15,16,37

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CLINICAL RESEARCH

STUDIES CONDUCTED WHICH INCLUDE ALPHA LIPOIC ACID AND MYO-INOSITOL HAVE SHOWN:11,16,27

  • Increase in sperm count16
  • Increase in normal sperm morphology (size, shape and cellular properties)16
  • Increase in progressive sperm motility (movement)16
  • Increase in successful partner pregnancy rate16

 

 

 

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More Information
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  1. Barthelmess EK, Naz RK. Polycystic ovary syndrome: current status and future perspective. Front Biosci(Elite Ed). 2015;6:104–119.
  2. Sinopol® package insert, February 2019.
  3. Dennett CC, Simon J. The role of polycystic ovary syndrome in reproductive and metabolic health: overview and approaches for treatment. Diabetes Spectr. 2015;28(2):116–120. doi:10.2337/diaspect.28.2.116.
  4. Rago R, Marcucci I, Leto G, Caponecchia L, Salacone P, Bonanni P, et al. EFFECT
    OF MYO-INOSITOL AND ALPHA-LIPOIC ACID ON OOCYTE QUALITY IN POLYCYSTIC OVARY SYNDROME NON-OBESE WOMEN UNDERGOING IN VITRO FERTILIZATION: A PILOT STUDY. J Biol Regulators Homeostatic Agents 2015;29(4):1-11.
  5. Bellver J, Rodriguez-Tabernero L, Robles A, Munoz E, Martinez F, Landeras E, et al. Group of interest in Reproductive Endocrinology (GIER) of the Spanish Fertility Society (SEF). Polycystic ovary syndrome throughout a woman’s life. J Assist Reprod Genet 2018;35:25-39. DOI 10.1007/s10815-017-1047-7.
  6. PCOS Awareness Association. What is Polycystic Ovarian Syndrome (PCOS) [online] [cited 26 August 2020]. Available from URL: https://www.pcosaa.org/overview. 
  7. WebMD®. Insulin Resistance [online] July 2019[cited 11 January 2021]; Available from URL: https://www.webmd.com/diabetes/insulin-resistance-syndrome. 
  8. Cappelli V, Musacchio MC, Bulfoni A, Morgante G, De Leo V. Natural molecules for the therapy of hyperandrogenism and metabolic disorders
    in PCOS. Eur Rev Med Pharmacol Sci 2017; 21(2 Suppl):15-29.
  9. Sirmans SM, Pate KA. Epidemiology, diagnosis, and management of polycystic ovary syndrome. Clin Epidemiol 2014;6:1-13. http://dx.doi.org/10.2147/CLEP.S37559.
  10. De Cicco S, Immediata V, Romualdi D, Policola C, Tropea A, Di Florio C, et al. Myoinositol combined with alpha-lipoic acid may improve the clinical and
    endocrine features of polycystic ovary syndrome through an insulin-independent action. Gynecol Endocrinol 2017;33(9):698-701. DOI: 10.1080/09513590.2017.1313972.
  11. Haghighian HK, Haidari F, Mohammadi-asl J, Datfar M. Randomized, triple-blind, placebo-controlled clinical trial examining the effects of alpha-lipoic acid supplement on the spermatogram and seminal oxidative stress in infertile men. Fertil Steril 2015;104:318-24. http://dx.doi.org/10.1016/j.fertnstert.2015.05.014.
  12. Carbonelli MG, Di Renzo L, Bigioni M, Di Daniele N, De Lorenzo A, Fusco MA. α-Lipoic Acid Supplementation: A Tool for Obesity Therapy? Curr Pharmaceut Design 2010;16:840-846.
  13. Iezzi ML, Varriale G, Torge N, Lasorella S, Zagaroli L, Verrotti A. POLYCYSTIC OVARY SYNDROME IN ADOLESCENCE: NEW THERAPEUTIC APPROACH WITH INOSITOL AND ALPHA-LIPOIC ACID. Int J Curr Res 2017;9(7):54006- 54011.
  14. Genazzani AD, Shefer K, Della Casa D, Prati A. Modulatory effects of alpha‑lipoic acid (ALA) administration on insulin sensitivity in obese PCOS patients. J Endocrinol Invest 2018;41:583 -590.
  15. Sinopol® him package insert, October 2019.
  16. Canepa P, Dal Lago A, De Leo C, Gallo M, Rizzo C, Licata E, et al. Combined treatment with myo-inositol, alphalipoic acid, folic acid and vitamins significantly improves sperm parameters of sub-fertile men: a multi-centric study.
    Eur Rev Med Pharmacol Sci 2018;22:7078-7085.
  17. World Health Organisation. Sexual and reproductive health. Infertility definitions and terminology [online] [cited 6 April 2020]; Available from URL:https://www.who.int/reproductivehealth/ topics/
    infertility/definitions/en/.
  18. Agarwal A, Virk G, Ong C, du Plessis SS. Effect of Oxidative Stress on Male Reproduction. World J Mens Health 2014;32(1):1-17. http://dx.doi.org/10.5534/wjmh.2014.32.1.1.
  19. Loma Linda University. Center for Fertility & IVF. Semen Analysis [online] [cited 27 August 2020]; Available from URL: https://lomalindafertility.com/ treatments/fertilitytesting/for-men/semen analysis/#:~:text=A%20semen%20analysis%20is%20often%20one%20of%20the,and%20 quality%20of%20sperm%20in%20the%20semen%20sample.
  20. Naz M, Kamal M. Classification, causes, diagnosis
    and treatment of male infertility: a review. Orient Pharm Exp Med 2017;17:89-109. DOI 10.1007/s13596- 017-0269-7.
  21. Lobo V, Patil A, Phatak A, et al. Free radicals, antioxidants and functional foods: Impact on human health. Pharmacogn Rev. 2010;4(8):118–126.
  22. Pizzino G, Irrera N, Cucinotta M, et al. Oxidative Stress: Harms and Benefits for Human Health. Oxid Med Cell Longev. 2017;2017:8416763.
  23. Agarwal A, Aponte-Mellado A, Premkumar BJ, Shaman A, Gupta S. The effects of
    oxidative stress on female reproduction: a review. Reprod Biol Endocrinol 2012;10:49. http://www. rbej.com/content/10/1/49.
  24. Lord T, Aitken RJ. Oxidative stress and ageing of the post-ovulatory oocyte. Reproduction 2013;146:R217–R227. DOI: 10.1530/REP-13-0111.
  25. Konrad D, Somwar R, Sweeney G, Yaworski K, Hayashi M, Ramlal T, et al. The Antihyperglycemic Drug a-Lipoic Acid Stimulates Glucose Uptake via Both GLUT4 Translocation and GLUT4 Activation. Potential Role of p38
    Mitogen-Activated Protein Kinase in GLUT4 Activation. Diabetes 2001;50:1464–1471.
  26. Derosa G, D’Angelo A, Romano D, Maffioli P. A Clinical Trial about a Food Supplement Containing α-Lipoic Acid on Oxidative Stress Markers in Type 2 Diabetic
    Patients. Int J Mol Sci 2016;17:1802. doi:10.3390/ijms17111802.
  27. Condorelli RA, La Vignera S, Mongioi LM, Vitale SG, Lagana AS, Cimino L, et al. Myo-inositol as a male fertility molecule: speed them up! Eur Rev Med Pharmacol Sci 2017;21(suppl 2):30-35.
  28. Smits RM, Mackenzie-Proctor R, Yazdani A, Stankiewicz MT, Jordan V, Showell MG. Antioxidants for male subfertility (Review) Cochrane Database of Systematic Reviews 2019; 3. Art. No.: CD007411.DOI: 10.1002/14651858.CD007411.pub4.
  29. De Rose AF, Baldi M, Gallo F, Rossi P, Gattuccio I, Marino A, et al. The management of male infertility: from nutraceuticals to diagnostics. IJMDAT 2018;1(1):e110.
  30. Lafuente R, Gonzalez-Comadran M, Sola I, Lopez G, Brassesco M, Carreras R,
    et al. Coenzyme Q10 and male infertility: a meta-analysis. J Assist Reprod Genet 2013. DOI 10.1007/s10815-013-0047-5.
  31. Omar MI, Pal RP, Kelly BD, Bruins HM, Yuan Y, Diemer T, et al. Benefits of Empiric Nutritional and Medical Therapy for Semen Parameters and Pregnancy and Live Birth Rates in Couples with Idiopathic Infertility: A Systematic Review and Meta-analysis. Eur Urol 2019. https://doi.org/10.1016/j. eururo.2018.12.022.
  32. Safarinejad MR. Efficacy of Coenzyme Q10 on Semen Parameters, Sperm Function and Reproductive Hormones in Infertile Men. J Urol 2009;182(1):237-248. DOI:10.1016/j.juro.2009.02.121.
  33. Balercia G, Buldreghini E, Vignini A, Tiano L, Paggi F, Amoroso S, et al. Coenzyme Q10 treatment in infertile men with idiopathic asthenozoospermia: a placebo-controlled, double-blind randomized trial. Fertil Steril 2009;91(5):1785–92.
    doi:10.1016/j. fertnstert.2008.02.119.
  34. Fallah A, Mohammad-Hasani A, Colagar AH. Zinc is an Essential Element for Male
    Fertility: A Review of Zn Roles in Men’s Health, Germination, Sperm Quality, and Fertilization. J Reprod Infertil. 2018;19(2):69-81.
  35. Fatima P, Begum N, Ishrat S, Banu J, Anwary SA, Rolly SJ, et al. Zinc Supplementation in Male Infertility. BSMMU J 2015;8(1):9-13.
  36. Foresta C, Flohe L, Garolla A, Roveri A, Ursini F, Maiorino M. Male Fertility Is Linked to the Selenoprotein Phospholipid Hydroperoxide Glutathione Peroxidase. Biol Reprod 2002;67:967-971. DOI 10.1095/biolreprod.102.003822.
  37. Boxmeer JC, Smit M, Weber RF, Lindemans J, Romijn JC, Eijkemans MJ, et al. Seminal Plasma Cobalamin Significantly Correlates With Sperm Concentration in Men Undergoing IVF or ICSI Procedures. J Androl 2007;28(4):521–527. DOI: 10.2164/jandrol.106.001982.

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