[Antioxidants as part of preconception preparation in men over 45 years of age].

Introduction: The reproductive potential of older men is influenced by the androgen deficiency and an increased risk of sperm DNA damage. In addition, with aging, a number of other diseases may have a detrimental effect on spermatogenesis. For this reason, the search for methods for correcting impaired spermatogenesis in men of the older age group is of relevance. The use of dietary supplements with antioxidant effects seems promising.

Aim: To increase the efficiency of preconception preparation for men aged 45 years and older using an antioxidant complex.

Materials and methods: A total of 102 patients aged 45 years and older with pathospermia and metabolic syndrome (MS) of varying severity were included in the study. The main group consisted of 52 patients aged 45 to 55 years, while in the control group there were 50 patients (45-54 years). In addition to standard therapy for MS, patients of the main group received the dietary supplement "Speroton", 1 sachet 2 times a day with meals for 3 months. In the control group, men received only standard therapy for MS. The results were assessed after 3 and 6 months from the start of treatment. A sperm analysis was used as the main criterion for assessing treatment efficiency. Sperm DNA damage was characterized by DNA fragmentation. In addition, the concentration of zinc in seminal plasma, as well as the total antioxidant activity (TAA), was determined for all patients. Laboratory analysis of sex hormones, carbohydrate metabolism parameters, and lipid profile was also performed.

Results: As a result of the adding the antioxidant complex "Speroton", the indicators of oxidative stress in the main group decreased almost two-fold. By the 6th month, the level of immunoreactive insulin (IRI) decreased by 22%, which was accompanied by a decrease in the level of glycosylated hemoglobin (HbA1c) by 6.6%, indicating stabilization of carbohydrate metabolism. Positive dynamics in reducing body mass index (BMI) by almost 12% in the main group were seen, as well as normalization of the lipid profile. In addition, there was a significant increase in sperm concentration from 10.5+/-5.5 million/ml to 21.5+/-4.8 after 3 months of taking the antioxidant complex "Speroton", positive dynamics were also noted in terms of DNA fragmentation, TAA level and zinc level in seminal plasma.

Conclusions: The use of the antioxidant complex "Speroton" in an increased dose of 2 sachets per day for 3 months in men older than 45 years with pathospermia and MS of varying severity improves the qualitative and quantitative sperm indicators and the morphological state of the male reproductive system. A determination of the level of zinc in seminal plasma, TAA, as well as the sperm DNA fragmentation, especially in patients aged 45 years and older suffering from MS, is justified. The use of the "Speroton" results in a decrease in the percentage of sperm with DNA fragmentation and the oxidative stress in the ejaculate. The adding of antioxidants in the dietary supplement "Speroton" in men with pathospermia and MS of varying severity allows to effectively restore the sensitivity of insulin receptors and normalize carbohydrate and lipid metabolism.