A 2026 expert consensus from the Global Andrology Forum reviews how antioxidants are used in male infertility, showing which practices are supported by expert agreement and where evidence is still lacking.
Sperm DNA fragmentation (SDF)
A 2025 review found that sperm DNA fragmentation testing provides useful insight into male infertility and may help in select cases, but inconsistent evidence, lack of test standardization, and variable results limit its routine use in fertility care.
A 2025 randomized trial found that men who took the combined antioxidant supplement Impryl for six months had no improvement in semen quality or pregnancy rates, and in some cases slightly worse outcomes, suggesting that routine antioxidant use may do more harm than good for some male infertility patients.
In a 2025 study, the sperm selection device Zymot modestly improved blastocyst development compared with conventional sperm processing method (density gradient centrifugation) in donor egg cycles using frozen sperm, though fertilization rates were similar.
While multiple studies have shown the benefit of antioxidant supplements in improving male fertility, what effect excessive supplementation has isn’t clear. This post combines a new study with older studies that show high levels of supplements can harm male fertility. However, these studies all have their limitations, and better quality research is needed to draw conclusions.
A 2024 randomized controlled trial (RCT) found that Zymot-selected sperm didn’t improve embryo euploidy rates, but increased fertilization rates. An important limitation of this study is that it was done in the general IVF population and not in individuals with high sperm DNA fragmentation.
Researchers in a 2023 study review the use of 27 IVF add-ons and provide recommendations by ESHRE, with only several that are recommended or could be considered for the general infertility population.
Researchers in a 2023 study evaluated 34 common male fertility sperm supplement brands for safety and efficacy. They found that the majority exceeded the recommended daily allowance, with two that exceeded the tolerable upper intake level. Less than half had supporting studies for their use, with the overall quality of evidence being ranked as poor.
Researchers in a 2023 study combined the results of 74 studies to investigate what factors contribute to euploid live birth and miscarriage rates, identifying embryo quality, maternal age, specific diagnoses, repeat freeze/thaw, and other factors.
Researchers in a 2022 study performed a systematic review and meta-analysis on infertile men who used antioxidant supplements, and found a benefit in pregnancy and semen parameter outcomes.
Researchers in a 2021 study found that older women showed worsened IVF outcomes using sperm with high DNA fragmentation, possibly due to compromised DNA repair activity in the older egg.
Researchers in a 2020 study report on the results of the MOXI trial that tested the effectiveness of a sperm supplement cocktail (containing vitamin C, vitamin D, vitamin E, selenium, and more) and found no benefit.
Researchers in a 2020 study found that sperm from males in couples with recurrent pregnancy loss were more likely to be aneuploid, potentially leading to the diagnosis.
Researchers in a 2019 study compared IVF outcomes from men with low or high sperm DNA fragmentation, finding that high SDF patients had poorer quality blastocysts and a higher chance of miscarriage.
Embryo arrest is when an embryo stops developing, usually before reaching the blastocyst stage. This post explains possible causes, including embryonic genome activation, maternal effect genes, the subcortical maternal complex, aneuploidy, mitochondrial dysfunction, oxidative stress, lab conditions, and sperm DNA fragmentation.
