The relationship of plasma antioxidant levels to semen parameters: the Males, Antioxidants, and Infertility (MOXI) randomized clinical trial

Jennifer F. Knudtson, Fangbai Sun, R. Matthew Coward, Karl R. Hansen, Kurt T. Barnhart, James Smith, Richard S. Legro, Michael P. Diamond, Stephen A. Krawetz, Heping Zhang, Rebecca Usadi, Valerie L. Baker, Nanette Santoro, Anne Z. Steiner

Research output: Contribution to journalArticlepeer-review

10 Scopus citations


Purpose: The understanding of the role of plasma antioxidant levels in male fertility in the USA is limited. In a secondary analysis of the Males, Antioxidants, and Infertility (MOXI) randomized clinical trial, we sought to determine whether serum levels of vitamin E (α-tocopherol), zinc, and selenium were correlated with semen parameters and couple fertility outcomes. Methods: This study is a secondary analysis of the MOXI clinical trial. The primary endpoints in this secondary analysis include semen parameters, and DNA fragmentation and clinical outcomes including pregnancy and live birth. Analyses were completed using Wilcoxon’s rank-sum test and linear regression models. Results: At baseline, the analysis included plasma labs for vitamin E (n = 131), selenium (n = 124), and zinc (n = 128). All baseline plasma values were in the normal ranges. There was no association between selenium, zinc, or vitamin E levels and semen parameters or DNA fragmentation. Baseline antioxidant levels in the male partners did not predict pregnancy or live birth among all couples. Among those randomized to placebo, baseline male antioxidant levels did not differ between those couples with live birth and those that did not conceive or have a live birth. Conclusions: Among men attending fertility centers in the USA, who have sufficient plasma antioxidant levels of zinc, selenium, or vitamin E, no association was observed between vitamins and semen parameters or clinical outcomes in couples with male infertility. Higher levels of antioxidants among men with circulating antioxidants in the normal range do not appear to confer benefit on semen parameters or male fertility.

Original languageEnglish (US)
Pages (from-to)3005-3013
Number of pages9
JournalJournal of Assisted Reproduction and Genetics
Issue number11
StatePublished - Nov 2021

All Science Journal Classification (ASJC) codes

  • Reproductive Medicine
  • Genetics
  • Obstetrics and Gynecology
  • Developmental Biology
  • Genetics(clinical)


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