Aim: The aim of this study was to investigate the role of folic acid and zinc sulfate supplementation on improvement of sperm functions in infertile male with oligoasthenoteratozoospermia (OAT) and their effects in relation to polymorphism of genes involved in folate metabolism.
Material and methods: 83 OAT men, who were attended to Avicenna Infertility Clinic (AIC), participated in a 16-week intervention study consisting of a daily treatment with a combination of folic acid (5 mg/day) and zinc sulphate (220 mg/day), and placebo in four experimental groups. Before and after treatment, standardized semen and blood samples were obtained for determinations of sperm concentration, motility, and morphology according to World Health Organization guidelines; sperm chromatin assay using toloidine blue (TB), aniline blue (AB), acridine orange (AO) and Chromomycin A3 (CMA3) staining methods; and semen and blood folate (RIA technique), zinc (atomic absorption) and TAC (spectrophotometry), MDA (fluorometric assay) concentrations. PCR-RFLP was performed to detect single nucleotide polymorphisms in genes of MTHFR (C677T) and MTRR (A66G).
Results: After intervention treatment, sperm concentration significantly increased in subfertile males receiving the combined treatment with folic acid and zinc sulphate and also group receiving only the treatment with folic acid. Sperm chromatin integrity was significantly improved in subfertile males receiving only zinc sulphate supplement. Lipid peroxidation and TAC did not show significant different between groups. The frequency of the MTHFR genotypes in normozoospia and OAT men was not statistically different (p=0.1) while the frequency of MTRR genotypes was statistically different (p=0.02).
Conclusions: The supplementation of zinc and folic acid to infertile men with OAT will improve semen quality and male fertility. In addition, C677T polymorphism in MTHFR gene is not as a risk factor for Iranian male infertility but A66G polymorphism in MTRR gene may be for it.