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Oral Antioxidants
• Vitamin C 500mg/d
• Vitamin E 400 mg/d
• Folic acid 2.5 mg/d
• Methyl folate 2.5 mg/d
• Co-enzyme Q10 Ubiquinol 100 mg/d • Zinc chelate 30 mg/d
• Cooper chelate 1mg/d
• Selenium 50 mcg/d
• L-carnitine 100 mg/d
• Acetil L-carnitine 500 mg/d • L-arginine 250 mg/d
• L-tyrosin 100 mg/d
• Lycopene 8mg/d
• Chrome GTF 100 mg/d
• Gluthatione setria 250 mg/d • NAC 400 mg/d
Duration:
• At least 3 months
Esteves & Agarwal Int Braz J Urol 2011; Majzoub, Agarwal & Esteves. Transl Androl Urol. 2017
Outcome Magnitude of effect
measure
(OR or MD; 95% CI)
Live birth 1.8 [1.2, 2.7]
7 RCTs; 750 men; P=0.005
DFI%
-5.0% [-12.6, 2.60] 4 RCTs*; 233 men; P=0.20
*MD -10.0%, 95% CI -12.9% to -7.2%, 219 men, after removal of one study involving men with varicocele
Smits et al. Cochrane Database Syst Rev 2019 Esteves, 37
Esteves, 37
Indications
Borderline abnormal (or normal) semen parameters with risk factor:
• SDFtestingshouldbeofferedtopatientswhohaveamodifiable lifestyle risk factor of male infertility (grade C recommendation)
• Testresultscanhelpreinforcetheimportanceoflifestyle modification (e.g., cessation of cigarette smoking, antioxidant therapy) and monitor the patient’s response to intervention (grade C recommendation)
Agarwal et al. Transl Androl Urol 2017
Esteves, 38
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PRECONGRESS COURSE 01 I VIENNA, AUSTRIA – 23 JUNE 2019 43
