The Effectiveness of Four Commonly Used Oral Nutraceuticals in Improving the Sperm Quality in Male Infertility: A Network Meta-Analysis

doi:10.12280/gjszjk.20240629

Abstract

Abstract:

Objective: To evaluate the efficacy of oral nutritional supplements, including coenzyme Q10 (CoQ10), vitamin E, inositol, and vitamin D, in improving sperm concentration, motility, morphology, count, and semen volume in male infertility patients, by a network Meta-analysis. Methods: Search PubMed, Web of Science, the Cochrane Library databases, CNKI, Wanfang Data, VIP and SinoMed from their inception to September 1, 2024. All of randomized controlled trials that evaluate the effects of oral nutritional supplements on male infertility patients were included in this network Meta-analysis. Results: A total of 13 studies involving 1 094 infertile men were included in this research. Inositol (MD=3.88, 95%CI: 0.59-7.17) significantly improved the sperm concentration, compared to placebo. CoQ10 (MD=6.45, 95%CI: 3.23-9.67); and inositol (MD=5.99, 95%CI: 1.91-10.08) successfully enhanced sperm motility. CoQ10 (MD=1.98, 95%CI: 1.29-2.68) and vitamin D+Ca (MD=-0.70, 95%CI: -1.29--0.11) effectively improved sperm morphology, while CoQ10 (MD=13.84, 95%CI: 1.49-26.19) successfully increased sperm count. Vitamin D+Ca (MD=0.40, 95%CI: 0.30-0.46) improved semen volume. No significant differences were observed between the vitamin D and vitamin E groups and the placebo group for the five target parameters. Conclusions: CoQ10, inositol, and vitamin D+Ca were demonstrated the better effects in improving semen quality in male infertility patients.

Key words: Infertility, male, Semen analysis, Inositol, Vitamin E, Network Meta-analysis, Ubiquinone, Coenzyme Q10

WANG Heng-yang, HU Rong, FAN Wei, ZHANG Li-hong, ZHANG Zhi-gang. The Effectiveness of Four Commonly Used Oral Nutraceuticals in Improving the Sperm Quality in Male Infertility: A Network Meta-Analysis[J]. Journal of International Reproductive Health/Family Planning, 2025, 44(3): 192-200.

Figures/Tables 12

References 47

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文献	国家	样本量（例）		干预措施		相关结局	年龄（岁）		干预时间
文献	国家	试验组	对照组	试验组	对照组	相关结局	试验组	对照组	干预时间
Montanino Oliva等^[13]	意大利	43	43	肌醇栓剂	安慰剂栓剂	②⑤	25~39	25~39	直到妊娠
Maghsoumi-Norouzabad等^[14]	伊朗	43	43	维生素D 4 000 IU/d	安慰剂 4 000 IU/d	②③④⑤	35.13±5.51	34.44±5.07	12周
Sabetian等^[15]	伊朗	63	61	维生素E 400 IU/d	安慰剂 400 IU/d	②③⑤	35.76±7.24	36.72±6.61	8周
Capece等^[16]	意大利	28	28	肌醇1 000 mg， 1次/d	安慰剂1 000 mg，1次/d	①②③	28.4±6.6	28.8±5.2	12周
Calogero等^[17]	意大利	98	96	肌醇2 000 mg， 2次/d	安慰剂2 000 mg，1次/d	①②	28	28	12周
Eslamian等^[18]	加拿大	15	16	维生素E 600 IU/d	安慰剂600 IU/d	①②③④⑤	32.80±4.13	33.04±4.08	12周
Ener等^[19]	土耳其	22	23	维生素E 300 mg，2次/d	安慰剂 300 mg，2次/d	④	26.5±5.0	25.2±4.3	12周
Safarinejad等^[20]	伊朗	101	102	CoQ10 200 mg/d	安慰剂 200 mg/d	②③④⑤	31	32	26周
Safarinejad^[21]	伊朗	98	96	CoQ10 300 mg/d	安慰剂 300 mg/d	②③④⑤	28±9	28±10	26周
Nadjarzadeh等^[22]	伊朗	23	24	CoQ10 200 mg/d	安慰剂 200 mg/d	①②③	34.17±4.52	34.67±6.69	12周
Balercia等^[23]	意大利	28	27	CoQ10 200 mg/d	安慰剂 200 mg/d	①②	32	32	24周
Blomberg Jensen等^[24]	丹麦	133	136	维生素D 1 400 IU+钙500 mg/d	安慰剂 500 mg/d	①②③④⑤	34.3±6.2	35.2±6.8	24周
Amini等^[25]	伊朗	31	31	维生素 D 50 000 IU/周	安慰剂 50 000 IU/周	①③⑤	34.37±4.83	34.86±4.65	12周

文献	国家	样本量（例）		干预措施		相关结局	年龄（岁）		干预时间
文献	国家	试验组	对照组	试验组	对照组	相关结局	试验组	对照组	干预时间
Montanino Oliva等^[13]	意大利	43	43	肌醇栓剂	安慰剂栓剂	②⑤	25~39	25~39	直到妊娠
Maghsoumi-Norouzabad等^[14]	伊朗	43	43	维生素D 4 000 IU/d	安慰剂 4 000 IU/d	②③④⑤	35.13±5.51	34.44±5.07	12周
Sabetian等^[15]	伊朗	63	61	维生素E 400 IU/d	安慰剂 400 IU/d	②③⑤	35.76±7.24	36.72±6.61	8周
Capece等^[16]	意大利	28	28	肌醇1 000 mg， 1次/d	安慰剂1 000 mg，1次/d	①②③	28.4±6.6	28.8±5.2	12周
Calogero等^[17]	意大利	98	96	肌醇2 000 mg， 2次/d	安慰剂2 000 mg，1次/d	①②	28	28	12周
Eslamian等^[18]	加拿大	15	16	维生素E 600 IU/d	安慰剂600 IU/d	①②③④⑤	32.80±4.13	33.04±4.08	12周
Ener等^[19]	土耳其	22	23	维生素E 300 mg，2次/d	安慰剂 300 mg，2次/d	④	26.5±5.0	25.2±4.3	12周
Safarinejad等^[20]	伊朗	101	102	CoQ10 200 mg/d	安慰剂 200 mg/d	②③④⑤	31	32	26周
Safarinejad^[21]	伊朗	98	96	CoQ10 300 mg/d	安慰剂 300 mg/d	②③④⑤	28±9	28±10	26周
Nadjarzadeh等^[22]	伊朗	23	24	CoQ10 200 mg/d	安慰剂 200 mg/d	①②③	34.17±4.52	34.67±6.69	12周
Balercia等^[23]	意大利	28	27	CoQ10 200 mg/d	安慰剂 200 mg/d	①②	32	32	24周
Blomberg Jensen等^[24]	丹麦	133	136	维生素D 1 400 IU+钙500 mg/d	安慰剂 500 mg/d	①②③④⑤	34.3±6.2	35.2±6.8	24周
Amini等^[25]	伊朗	31	31	维生素 D 50 000 IU/周	安慰剂 50 000 IU/周	①③⑤	34.37±4.83	34.86±4.65	12周

相关结局	干预方法	纳入研究（篇）	异质性检验		效应模型	MD（95%CI）	P
相关结局	干预方法	纳入研究（篇）	I²	P	效应模型	MD（95%CI）	P
精子浓度	肌醇	2^[16-17]	89%	0.003	随机	3.86（0.25~7.47）	0.04
	CoQ10	2^[22-23]	0%	0.87	固定	-0.04（-0.43~0.34）	0.83
精子活力	肌醇	3^{[13,16 -17]}	72%	0.03	随机	5.07（2.01~8.13）	0.001
	维生素E	2^[15,18]	0%	0.85	固定	0.35（-1.96~2.66）	0.77
	CoQ10	4^[20-23]	98%	<0.000 1	随机	6.21（1.75~10.68）	0.006
精子形态	维生素E	2^[15,18]	0%	0.85	固定	-0.13（-0.59~0.34）	0.59
	维生素D	2^[14,25]	0%	0.53	固定	0.04（-0.43~0.52）	0.86
	CoQ10	3^[20-22]	47%	0.15	固定	1.95（1.41~2.50）	<0.000 1
精子数量	维生素E	2^[18-19]	84%	0.01	随机	7.73（-11.22~26.68）	0.42
	CoQ10	2^[20-21]	89%	0.003	随机	13.82（5.89~21.76）	0.000 6
精液体积	维生素E	2^[15,18]	0%	0.71	固定	-0.05（-0.24~0.15）	0.64
	维生素D	2^[14,25]	0%	0.93	固定	-0.23（-0.84~0.37）	0.45
	CoQ10	2^[20-21]	0%	0.75	固定	-0.05（-0.35~0.25）	0.73

相关结局	干预方法	纳入研究（篇）	异质性检验		效应模型	MD（95%CI）	P
相关结局	干预方法	纳入研究（篇）	I²	P	效应模型	MD（95%CI）	P
精子浓度	肌醇	2^[16-17]	89%	0.003	随机	3.86（0.25~7.47）	0.04
	CoQ10	2^[22-23]	0%	0.87	固定	-0.04（-0.43~0.34）	0.83
精子活力	肌醇	3^{[13,16 -17]}	72%	0.03	随机	5.07（2.01~8.13）	0.001
	维生素E	2^[15,18]	0%	0.85	固定	0.35（-1.96~2.66）	0.77
	CoQ10	4^[20-23]	98%	<0.000 1	随机	6.21（1.75~10.68）	0.006
精子形态	维生素E	2^[15,18]	0%	0.85	固定	-0.13（-0.59~0.34）	0.59
	维生素D	2^[14,25]	0%	0.53	固定	0.04（-0.43~0.52）	0.86
	CoQ10	3^[20-22]	47%	0.15	固定	1.95（1.41~2.50）	<0.000 1
精子数量	维生素E	2^[18-19]	84%	0.01	随机	7.73（-11.22~26.68）	0.42
	CoQ10	2^[20-21]	89%	0.003	随机	13.82（5.89~21.76）	0.000 6
精液体积	维生素E	2^[15,18]	0%	0.71	固定	-0.05（-0.24~0.15）	0.64
	维生素D	2^[14,25]	0%	0.93	固定	-0.23（-0.84~0.37）	0.45
	CoQ10	2^[20-21]	0%	0.75	固定	-0.05（-0.35~0.25）	0.73

干预措施	精子浓度		精子活力		精子形态		精子数量		精液体积
干预措施	SUCRA（%）	等级	SUCRA（%）	等级	SUCRA（%）	等级	SUCRA（%）	等级	SUCRA（%）	等级
安慰剂	46.7	3.7	28.5	4.6	57.7	2.7	32.7	3.7	46.9	3.1
维生素E	46.9	3.7	31.0	4.5	45.2	3.2	63.5	2.5	32.5	3.7
CoQ10	42.4	3.9	82.3	1.9	100.0	1.0	88.7	1.5	32.9	3.7
维生素D	29.5	4.5	75.0	2.2	37.5	3.5	39.9	7.8	38.2	3.5
肌醇	91.1	1.4	78.6	2.1	-	-	-	-	-	-
维生素D+钙	43.4	3.8	4.6	5.8	9.6	4.6	25.3	6.5	99.4	1.0