Original Papers - Andrology

Therapeutic supplementation with antioxidants and vitamins improved sperm motility among infertile men with idiopathic low spermatogenesis

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Received: 1 December 2025
Published: 2 March 2026
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Background: Spermatogenesis is worsened by reactive oxygen species (ROS) and antioxidants could reduce ROS induced sperm damage.
Methods: This prospective cohort study evaluated the potential therapeutic effects of a combination of vitamins, minerals and antioxidants on the sperm quality parameters of infertile men with idiopathic low spermatogenesis. Seminal fluid analysis tests were performed before treatment, 3 and 6 months after treatment.
Results: The treatment resulted in a significant improvement in the rate (%) of sperm motility from 16.95±6.93 to 23.11±8.87, after 3 months and reached 23.68±8.73 after 6 months (p=0.0006) whereas a non-significant increase in sperm count (from 13.05±8.1 to 15.79±7.9 after 3 months and 15.26±10.3 million/ml after 6 months (p=0.1650). Morphology and agglutination showed little changes. A positive correlation between sperm count and motility was observed after 3 months of treatment (r = 0.594; p=0.007).
Conclusions: The combination of vitamins and antioxidants improved the sperm motility significantly and to a lesser extent the sperm count, however, sperm morphology and agglutination remained relatively unchanged. Using antioxidants is safe and can improve semen parameters.

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1. Ko EY, Siddiqi K, Brannigan RE, Sabanegh ES. Empirical medical therapy for idiopathic male infertility: a survey of the American Urological Association. J Urol. 2012; 187:973-8. DOI: https://doi.org/10.1016/j.juro.2011.10.137

2. Kefer JC, Agarwal A, Sabanegh E. Role of antioxidants in the treatment of male infertility. Int J Urol. 2009; 16:449-57. DOI: https://doi.org/10.1111/j.1442-2042.2009.02280.x

3. Agarwal A, Baskaran S, Parekh N, et al. Male infertility. Lancet 2021; 397:319-33. DOI: https://doi.org/10.1016/S0140-6736(20)32667-2

4. Treatment of Infertility, Comhaire FH. Towards more objectivity in diagnosis and management of male infertility: results of a World Health Organization multicentre study. Oxford, Blackwell Scientific Publications; 1987.

5. Agarwal A, Parekh N, Panner Selvam MK, et al. Male oxidative stress infertility (MOSI): proposed terminology and clinical practice guidelines for management of idiopathic male infertility. World J Mens Health. 2019; 37:296-312. DOI: https://doi.org/10.5534/wjmh.190055

6. Majzoub A, Agarwal A, Esteves SC. Antioxidants for elevated sperm DNA fragmentation: a mini review. Transl Androl Urol. 2017;6:S649-53. DOI: https://doi.org/10.21037/tau.2017.07.09

7. Ighodaro OM, Akinloye OA. First line defence antioxidants-superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GPX): Their fundamental role in the entire antioxidant defence grid. Alexan J Med 2018; 54:287-93. DOI: https://doi.org/10.1016/j.ajme.2017.09.001

8. Hussein TM, Eldabah N, Zayed HA, Genedy RM. Assessment of serum vitamin D level and seminal vitamin D receptor gene methylation in a sample of Egyptian men with idiopathic infertility. Andrologia. 2021; 53:e14172. DOI: https://doi.org/10.1111/and.14172

9. WHO. Laboratory manual for the examination and processing of human semen, 6th ed. Available from: https://www.who.int/publications/i/item/9789240030787

10. Ahmadi S, Bashiri R, Ghadiri-Anari A, Nadjarzadeh A. Antioxidant supplements and semen parameters: An evidence based review. Int J Reprod Biomed. 2016;14:729-36. DOI: https://doi.org/10.29252/ijrm.14.12.729

11. Li K, Yang X, Wu T. The effect of antioxidants on sperm quality parameters and pregnancy rates for idiopathic male infertility: a network meta-analysis of randomized controlled trials. Front Endocrinol. 2022;13. DOI: https://doi.org/10.3389/fendo.2022.810242

12. Dimitriadis F, Borgmann H, Struck JP, et al. Antioxidant supplementation on male fertility—a systematic review. Antioxidants (Basel) 2023;12:836. DOI: https://doi.org/10.3390/antiox12040836

13. Ibitoye BO, Fasasi AO, Imosemi IO, et al. The spermiogram and correlation of seminal fluid parameters in patient attending fertility centre in Lagos, South West Nigeria. Morphologie. 2023;107:100606. DOI: https://doi.org/10.1016/j.morpho.2023.05.004

14. Lobo V, Patil A, Phatak A, Chandra N. Free radicals, antioxidants and functional foods: Impact on human health. Pharmacogn Rev. 2010; 4:118-26. DOI: https://doi.org/10.4103/0973-7847.70902

15. Arafa M, Agarwal A, Majzoub A, et al. Efficacy of antioxidant supplementation on conventional and advanced sperm function tests in patients with idiopathic male infertility. Antioxidants (Basel). 2020;9:219. DOI: https://doi.org/10.3390/antiox9030219

16. Ali M, Martinez M, Parekh N. Are antioxidants a viable treatment option for male infertility? Andrologia. 2021; 53:e13644. DOI: https://doi.org/10.1111/and.13644

17. Menezo Y, Evenson D, Cohen M, Dale B. Effect of antioxidants on sperm genetic damage. Adv Exp Med Biol. 2014; 791:173-89. DOI: https://doi.org/10.1007/978-1-4614-7783-9_11

18. Cardoso JP, Cocuzza M, Elterman D. Optimizing male fertility: oxidative stress and the use of antioxidants. World J Urol. 2019;37:1029-34. DOI: https://doi.org/10.1007/s00345-019-02656-3

19. Kumar R, Gautam G, Gupta NP. Drug therapy for idiopathic male infertility: rationale versus evidence. J Urol. 2006; 176:1307-12. DOI: https://doi.org/10.1016/j.juro.2006.06.006

20. Kumar N, Singh AK. Reactive oxygen species in seminal plasma as a cause of male infertility. J Gynecol Obstet Hum Reprod. 2018;47:565-72. DOI: https://doi.org/10.1016/j.jogoh.2018.06.008

21. Benedetti S, Tagliamonte MC, Catalani S, et al. Differences in blood and semen oxidative status in fertile and infertile men, and their relationship with sperm quality. Reprod Biomed Online 2012;25:300-6. DOI: https://doi.org/10.1016/j.rbmo.2012.05.011

22. Boushaba S, Helis Y, Lebaal R, et al. The relationship of sperm DNA integrity with serum vitamin levels (folate and cobalamin) and food consumption in infertile men. Clin Exp Reprod Med. 2023;50:53-62. DOI: https://doi.org/10.5653/cerm.2022.05736

23. Banihani SA. Vitamin B12 and semen quality. Biomolecules 2017; 7:42. DOI: https://doi.org/10.3390/biom7020042

24. Hosseinabadi F, Jenabi M, Ghafarizadeh AA, Yazdanikhah S. The effect of vitamin B12 supplement on post-thaw motility, viability and DNA damage of human sperm. Andrologia. 2020; 52:e13877. DOI: https://doi.org/10.1111/and.13877

25. Kumar N, Jadhao AG, Yadav RR. Correlation between serum vitamin B12, vitamin D, and suboptimal semen parameters in male infertility: A hospital-based cross-sectional study. J Family Med Prim Care. 2024; 13:5171-6. DOI: https://doi.org/10.4103/jfmpc.jfmpc_727_24

26. Arab A, Hadi A, Moosavian SP, et al. The association between serum vitamin D, fertility and semen quality: A systematic review and meta-analysis. Int J Surg 2019;71:101-9. DOI: https://doi.org/10.1016/j.ijsu.2019.09.025

27. Banks N, Sun F, Krawetz SA, et al. Male vitamin D status and male factor infertility. Fertil Steril 2021; 116:973-9. DOI: https://doi.org/10.1016/j.fertnstert.2021.06.035

28. Kumari S, Singh K, Kumari S, et al. Association of vitamin D and reproductive hormones with semen parameters in infertile men. Cureus. 2021; 13:e14511. DOI: https://doi.org/10.7759/cureus.14511

29. Maghsoumi-Norouzabad L, Labibzadeh M, Zare Javid A, et al. The association of vitamin D, semen parameters, and reproductive hormones with male infertility: A cross-sectional study. Int J Reprod Biomed. 2022; 20:331-8. DOI: https://doi.org/10.18502/ijrm.v20i4.10905

30. Kaltsas A. Oxidative stress and male infertility: the protective role of antioxidants. Medicina (Kaunas) 2023; 59:1769. DOI: https://doi.org/10.3390/medicina59101769

Ethics Approval

The study proposal was approved by the institutional ethics committee (Faculty of Medicine Ethics Committee - Mutah University) and was performed in compliance with Good Clinical Practice and following the Declaration of Helsinki

Data Availability Statement

The data supporting this study's findings are available from the corresponding author upon reasonable request.

Mohammad Salem Hareedy, Department of Pharmacology, Faculty of Medicine, Mutah University, Karak

Department of Pharmacology, Faculty of Medicine, Assiut University, Egypt

How to Cite



Therapeutic supplementation with antioxidants and vitamins improved sperm motility among infertile men with idiopathic low spermatogenesis. (2026). Archivio Italiano Di Urologia E Andrologia, 98(1). https://doi.org/10.4081/aiua.2026.14685