Volume 11, Issue 1 (2026)
SJMR 2026, 11(1): 13-21 |
Back to browse issues page
Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
Nateghi M R, Sanaye Naderi M, Mohammadian H, Saremi A. Effects of Astaxanthin on Human Sperm Morphology: A Systematic Review and Meta-Analysis. SJMR 2026; 11 (1) : 3
URL: http://saremjrm.com/article-1-388-en.html
URL: http://saremjrm.com/article-1-388-en.html
1- Sarem Gynecology, Obstetrics and Infertility Research Center, Sarem Women’s Hospital, Iran University of Medical Science (IUMS), Tehran, Iran. & Sarem Cell Research Center (SCRC), Sarem Women’s Hospital, Tehran, Iran.
2- Sarem Gynecology, Obstetrics and Infertility Research Center, Sarem Women’s Hospital, Iran University of Medical Sciences, Tehran, Iran. & Sarem Cell Research Center (SCRC), Sarem Women’s Hospital, Tehran, Iran.
3- Sarem Gynecology, Obstetrics and Infertility Research Center, Sarem Women’s Hospital, Iran University of Medical Sciences, Tehran, Iran.
2- Sarem Gynecology, Obstetrics and Infertility Research Center, Sarem Women’s Hospital, Iran University of Medical Sciences, Tehran, Iran. & Sarem Cell Research Center (SCRC), Sarem Women’s Hospital, Tehran, Iran.
3- Sarem Gynecology, Obstetrics and Infertility Research Center, Sarem Women’s Hospital, Iran University of Medical Sciences, Tehran, Iran.
Abstract: (19 Views)
Introduction: Oxidative stress plays a central role in the pathophysiology of male infertility, contributing to impaired sperm concentration, motility, morphology, and DNA integrity. Astaxanthin, a potent antioxidant carotenoid, has been proposed as a therapeutic agent for improving semen quality. However, clinical findings remain inconsistent. This systematic review and meta-analysis aimed to evaluate the effects of astaxanthin supplementation on conventional human semen morphology.
Methods: A systematic search of PubMed, Scopus, and Google Scholar was conducted up to December 2025 according to PRISMA guidelines. Randomized controlled trials evaluating the effects of astaxanthin supplementation on sperm morphology in adult men were included. Weighted mean differences (WMDs) with 95% confidence intervals (CIs) were calculated using a random-effects model based on changes from baseline. Between-study heterogeneity was assessed using the I² statistic.
Results: Four randomized controlled trials comprising 166 participants (86 interventions, 80 controls) met the inclusion criteria. Astaxanthin supplementation did not significantly affect sperm morphology (WMD: 0.02; 95% CI: -0.51, 0.55).
Conclusion: Current evidence does not support a significant beneficial effect of astaxanthin supplementation on conventional semen morphology in infertile men. Given the limited number of trials and substantial heterogeneity, larger well-designed randomized studies with standardized protocols and comprehensive reproductive endpoints are warranted.
Methods: A systematic search of PubMed, Scopus, and Google Scholar was conducted up to December 2025 according to PRISMA guidelines. Randomized controlled trials evaluating the effects of astaxanthin supplementation on sperm morphology in adult men were included. Weighted mean differences (WMDs) with 95% confidence intervals (CIs) were calculated using a random-effects model based on changes from baseline. Between-study heterogeneity was assessed using the I² statistic.
Results: Four randomized controlled trials comprising 166 participants (86 interventions, 80 controls) met the inclusion criteria. Astaxanthin supplementation did not significantly affect sperm morphology (WMD: 0.02; 95% CI: -0.51, 0.55).
Conclusion: Current evidence does not support a significant beneficial effect of astaxanthin supplementation on conventional semen morphology in infertile men. Given the limited number of trials and substantial heterogeneity, larger well-designed randomized studies with standardized protocols and comprehensive reproductive endpoints are warranted.
Article number: 3
Article Type: A Systematic Review and Meta-Analysis |
Subject:
Sterility
Received: 2026/05/5 | Accepted: 2026/05/15 | Published: 2026/06/17
Received: 2026/05/5 | Accepted: 2026/05/15 | Published: 2026/06/17
References
1. 1. Comhaire FH, El Garem Y, Mahmoud A, Eertmans F, Schoonjans F, Combined conventional/antioxidant "Astaxanthin" treatment for male infertility: a double blind, randomized trial. Asian J Androl, 2005. 7(3): 257-62. [DOI:10.1111/j.1745-7262.2005.00047.x] [PMID]
2. Nurmawati D, Hinting A, Sudjarwo, Effect of Antioxidant activity of Astaxanthin in improving Human Spermatozoa lipid Peroxidation. International Journal of Advances in Scientific Research and Engineering, 2019. 05: 98-108. [DOI:10.31695/IJASRE.2019.33537]
3. Ayub Mohammed Salih S, Jabarpour M, Sedighi Gilani MA, Sajadi H, Saedi Marghmaleki M, Shabani Nashtaei M, et al., The effect of astaxanthin after varicocele surgery on antioxidant status and semen quality in infertile men: A triple-blind randomized clinical trial. Food Sci Nutr, 2024. 12(10): 7977-7988. [DOI:10.1002/fsn3.4365] [PMID] [PMCID]
4. Kumalic SI, Klun IV, Bokal EV, Pinter B, Effect of the oral intake of astaxanthin on semen parameters in patients with oligo-astheno-teratozoospermia: a randomized double-blind placebo-controlled trial. Radiol Oncol, 2020. 55(1): 97-105. [DOI:10.2478/raon-2020-0062] [PMID] [PMCID]
5. Mahabadi JA, Bafrani HH, Nikzad H, Effect of Sesame-Supplemented Diet on Prostate and Seminal Vesicle Histology of Adult Rat. International Journal of Morphology, 2016. 34(2). [DOI:10.4067/S0717-95022016000200030]
6. Amini Mahabadi J, Karimian M, Aghighi F, Enderami SE, Seyyed Hosseini E, Talaei SA, et al., Retinoic acid and 17β-estradiol improve male germ cell differentiation from mouse-induced pluripotent stem cells. Andrologia, 2020. 52(2): e13466. [DOI:10.1111/and.13466] [PMID]
7. Kumar N, Singh AK, Impact of environmental factors on human semen quality and male fertility: a narrative review. Environmental Sciences Europe, 2022. 34(1): 6. [DOI:10.1186/s12302-021-00585-w]
8. Lee D, Innovations in assisted reproductive technology through the advances in artificial intelligence and image processing. Obstet Gynecol Sci, 2025. 68(6): 458-466. [DOI:10.5468/ogs.25229] [PMID] [PMCID]
9. Agarwal A, Saleh RA, Bedaiwy MA, Role of reactive oxygen species in the pathophysiology of human reproduction. Fertility and Sterility, 2003. 79(4): 829-843. [DOI:10.1016/S0015-0282(02)04948-8] [PMID]
10. Wang Y, Fu X, Li H, Mechanisms of oxidative stress-induced sperm dysfunction. Frontiers in Endocrinology, 2025. Volume 16 - 2025. [DOI:10.3389/fendo.2025.1520835] [PMID] [PMCID]
11. Shiva M, Gautam AK, Verma Y, Shivgotra V, Doshi H, Kumar S, Association between sperm quality, oxidative stress, and seminal antioxidant activity. Clinical Biochemistry, 2011. 44(4): 319-324. [DOI:10.1016/j.clinbiochem.2010.11.009] [PMID]
12. Kowalczyk A, The Role of the Natural Antioxidant Mechanism in Sperm Cells. Reproductive Sciences, 2022. 29(5): 1387-1394. [DOI:10.1007/s43032-021-00795-w] [PMID] [PMCID]
13. Sun C, Liu Z, Li Y, Wang J, Jiang Y, Zhao C, Beyond Antioxidant Monotony: Astaxanthin's Multi-Axis Anti-Ageing Mechanisms, and Innovations in Delivery Technology-A Review. Journal of Future Foods, 2025. [DOI:10.1016/j.jfutfo.2025.10.023]
14. Ali S, Kumar A, Liao Z, Iddrisu L, Cheng Y, Wang Y, et al., Astaxanthin: The king of carotenoid pigments as a natural solution to mitigate heat stress challenges in the poultry meat industry. Poultry Science, 2026. 105(1): 106155. [DOI:10.1016/j.psj.2025.106155] [PMID] [PMCID]
15. He J, Zhong Y, Li Y, Liu S, Pan X, Astaxanthin Alleviates Oxidative Stress in Mouse Preantral Follicles and Enhances Follicular Development Through the AMPK Signaling Pathway. International Journal of Molecular Sciences, 2025. 26(5): 2241. [DOI:10.3390/ijms26052241] [PMID] [PMCID]
16. Nishida Y, Nawaz A, Hecht K, Tobe K, Astaxanthin as a Novel Mitochondrial Regulator: A New Aspect of Carotenoids, beyond Antioxidants. Nutrients, 2021. 14(1). [DOI:10.3390/nu14010107] [PMID] [PMCID]
17. Thanintranon S, Saeng-Anan U, Vutyavanich T, Piromlertamorn W, Somsak P, Sanmee U, Effects of astaxanthin supplementation during vitrification and liquid nitrogen vapor freezing on motility, morphology, survival, reactive oxygen species (ROS), and DNA fragmentation of post-cryopreserved human sperm. JBRA Assist Reprod, 2024. 28(4): 611-617. [DOI:10.5935/1518-0557.20240056] [PMID] [PMCID]
18. Ashrafizadeh M, Ahmadi Z, Effect of Astaxanthin Treatment on the Sperm Quality of the Mice Treated with Nicotine. Reviews in Clinical Medicine, 2019. 6(1): 1-5.
19. Thanintranon S, Saeng-Anan U, Vutyavanich T, Piromlertamorn W, Somsak P, Sanmee U, Effects of astaxanthin supplementation during vitrification and liquid nitrogen vapor freezing on motility, morphology, survival, reactive oxygen species (ROS), and DNA fragmentation of post-cryopreserved human sperm. JBRA Assisted Reproduction, 2024. 28(4): 611. [DOI:10.5935/1518-0557.20240056] [PMID] [PMCID]
20. Moher D, Liberati A, Tetzlaff J, Altman DG, Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med, 2009. 6(7): e1000097. [DOI:10.1371/journal.pmed.1000097] [PMID] [PMCID]
21. Hozo SP, Djulbegovic B, Hozo I, Estimating the mean and variance from the median, range, and the size of a sample. BMC Med Res Methodol, 2005. 5: 13. [DOI:10.1186/1471-2288-5-13] [PMID] [PMCID]
22. Pourmand G, Movahedin M, Dehghani S, Mehrsai A, Ahmadi A, Pourhosein M, et al., Does L-carnitine therapy add any extra benefit to standard inguinal varicocelectomy in terms of deoxyribonucleic acid damage or sperm quality factor indices: a randomized study. Urology, 2014. 84(4): 821-5. [DOI:10.1016/j.urology.2014.07.006] [PMID]
23. Wang Y, Fu X, Li H, Mechanisms of oxidative stress-induced sperm dysfunction. Front Endocrinol (Lausanne), 2025. 16: 1520835. [DOI:10.3389/fendo.2025.1520835] [PMID] [PMCID]
24. Wu J-Y, Kang H-Y, Guo Y, Sheng X-H, Wang X-G, Xing K, et al., Effect of natural astaxanthin on sperm quality and mitochondrial function of breeder rooster semen cryopreservation. Cryobiology, 2024. 117: 104979. [DOI:10.1016/j.cryobiol.2024.104979] [PMID]
25. Mohammadi-Bardbori A, Shadboorestan A, Salehi E, Rahimi MA, Kargar-Abarghouei E, Amidi F, et al., Protective effects of astaxanthin on post‐thaw sperm quality in normozoospermic men. Andrologia, 2024. 2024(1): 2332443. [DOI:10.1155/2024/2332443]
26. Li C, Yan Y, Wang K, Jiang T, Astaxanthin alleviates oxidative stress and skeletal muscle damage by promoting mitochondrial biogenesis. Front Vet Sci, 2025. 12: 1577408. [DOI:10.3389/fvets.2025.1577408] [PMID] [PMCID]
27. Liu M-L, Wu J-Y, Sheng X-H, Xu Y-X, Xiao L-F, Wang X-G, et al., Natural astaxanthin enhances testosterone synthesis by improving mitochondrial function and reducing oxidative stress in Leydig cells. Poultry Science, 2026: 106663. [DOI:10.1016/j.psj.2026.106663] [PMID] [PMCID]
28. Sztretye M, Dienes B, Gönczi M, Czirják T, Csernoch L, Dux L, et al., Astaxanthin: A Potential Mitochondrial-Targeted Antioxidant Treatment in Diseases and with Aging. Oxidative Medicine and Cellular Longevity, 2019. 2019(1): 3849692. [DOI:10.1155/2019/3849692] [PMID] [PMCID]
29. Sohail T, Zhang L, Wang X, Jiang C, Wang J, Sun X, et al., Astaxanthin Improved the Quality of Hu Ram Semen by Increasing the Antioxidant Capacity and Mitochondrial Potential and Mitigating Free Radicals-Induced Oxidative Damage. Animals, 2024. 14(2): 319. [DOI:10.3390/ani14020319] [PMID] [PMCID]
30. Dede G, Saylan A, The effect of astaxanthin on human sperm parameters after cryopreservation. Can Urol Assoc J, 2022. 16(11): E552-e557. [DOI:10.5489/cuaj.7876] [PMID] [PMCID]
31. Ghantabpour T, Parvaneh S, Parsaie H, Ramzanian Gilani T, Tabaei MS, Amidi F, Overview of the effects of astaxanthin on the male reproductive system focusing on mechanism underling its action. European journal of pharmacology, 2025. 1005: 178033. [DOI:10.1016/j.ejphar.2025.178033] [PMID]
| Rights and permissions | |
 |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
