Evaluation of the effect of the combined antioxidant preparation Megaspermin Maca on spermatogenesis parameters and DNA fragmentation levels in men with idiopathic pathospermia

Male factor infertility remains one of the leading causes of reduced reproductive potential in couples, accounting for up to 50% of infertility cases. Traditional semen analysis parameters do not always reflect the true fertility status, as a significant proportion of men with normal ejaculate parameters are diagnosed with impaired sperm genetic integrity. One of the key mechanisms of sperm damage is oxidative stress. Consequently, pathogenetically substantiated complex antioxidant and metabolic support for spermatogenesis is of particular interest. Objective. To evaluate changes in spermatogenesis parameters and sperm DNA fragmentation levels in men with idiopathic pathospermia following administration of a combined antioxidant complex. Material and methods. A multicenter observational study included 118 men aged 25—55 years with idiopathic pathospermia. Participants received a combined antioxidant complex for 90 days. The following parameters were assessed: ejaculate volume, sperm concentration, progressive motility, sperm morphology and the level of DNA fragmentation measured by the TUNEL assay. Semen analysis was performed before the initiation of therapy and after three months of therapy. Results. Administration of the studied complex was associated with statistically significant improvement in the main parameters (volume, concentration, progressive motility and sperm morphology) and a reduction in DNA fragmentation levels (p<0.001). Positive dynamics of the corresponding parameters were noted in subgroups of patients with baseline oligozoospermia, asthenozoospermia and teratozoospermia (p<0.05). Conclusions. The use of combined antioxidant complex was associated with a statistically significant improvement in spermatogenesis parameters and a decrease in sperm DNA fragmentation levels in men with idiopathic pathospermia. The obtained findings suggest that pathogenetically oriented nutritional antioxidant support may represent a potentially promising approach for the management of spermatogenesis disorders. However, the observational design of the study and the absence of a control group limit the possibility of causal interpretation of the observed changes. Further randomized controlled studies are required to further evaluate these findings and their potential clinical significance.