{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T14:56:01Z","timestamp":1781535361853,"version":"3.54.5"},"reference-count":30,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T00:00:00Z","timestamp":1781481600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Nutr."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Varicocele is a leading cause of male infertility, primarily due to oxidative stress. This study aimed to investigate the relationship between dietary intake of antioxidants and micronutrients and semen quality in men with varicocele-related infertility.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective analysis was conducted on 380 men between January 2018 and December 2023. Dietary intake of Vitamin C, E, Zinc, Selenium, CoQ10, and L-carnitine was assessed using a validated food frequency questionnaire. Semen parameters and DNA Fragmentation Index (DFI) were compared among intake tertiles (T1\u2013T3) using ANOVA and multivariable linear regression, with adjustments for age, BMI, and smoking status.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A higher intake of antioxidants (T3) was found to be significantly associated with increased sperm concentration (38.79 vs. 33.70 million\/ml,\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.001), total motility (51.09% vs. 46.00%,\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.001), and improved morphology (\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.001). Regression models indicated that Zinc and CoQ10 were strong predictors of concentration, while Vitamin E and L-carnitine significantly predicted progressive motility (\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.001). Interestingly, Vitamin C intake showed an inverse correlation with DNA fragmentation (\u03b2 = \u22122.46,\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The findings consistently show that higher intake of certain micronutrients is linked to better semen quality and lower DNA damage in men with varicocele. This underscores the importance of optimizing nutrition as a crucial approach in addressing infertility related to varicocele.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fnut.2026.1838102","type":"journal-article","created":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T14:46:07Z","timestamp":1781534767000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of antioxidant and micronutrient intake on varicocele-associated infertility: a retrospective analysis"],"prefix":"10.3389","volume":"13","author":[{"given":"Dian","family":"Fu","sequence":"first","affiliation":[{"name":"Department of Urology, Nanjing Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University","place":["Nanjing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaowen","family":"Tan","sequence":"additional","affiliation":[{"name":"Department of Urology, Nanjing Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University","place":["Nanjing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhigang","family":"Zheng","sequence":"additional","affiliation":[{"name":"Fuxing Road Outpatient Department","place":["Jingnan Medical District of Chinese PLA General Hospital, Nanjing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoming","family":"Yi","sequence":"additional","affiliation":[{"name":"Department of Urology, Nanjing Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University","place":["Nanjing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Changjie","family":"Shi","sequence":"additional","affiliation":[{"name":"Department of Urology, Nanjing Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University","place":["Nanjing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ding","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Urology, Nanjing Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University","place":["Nanjing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Urology, Nanjing Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University","place":["Nanjing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haowei","family":"He","sequence":"additional","affiliation":[{"name":"Department of Urology, Nanjing Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University","place":["Nanjing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuejun","family":"Shang","sequence":"additional","affiliation":[{"name":"Department of Urology, Nanjing Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University","place":["Nanjing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,15]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1807","DOI":"10.21037\/tau-2025-120","article-title":"Risk factors associated with varicocele: a narrative review","volume":"14","author":"Shi","year":"2025","journal-title":"Transl Androl Urol"},{"key":"B2","doi-asserted-by":"publisher","first-page":"2210","DOI":"10.1001\/jama.2020.0397","article-title":"Varicoceles","volume":"323","author":"Sasson","year":"2020","journal-title":"JAMA"},{"key":"B3","doi-asserted-by":"publisher","first-page":"615","DOI":"10.1016\/j.eururo.2018.12.022","article-title":"Benefits of empiric nutritional and medical therapy for semen parameters and pregnancy and live birth rates in couples with idiopathic infertility: a systematic review and meta-analysis","volume":"75","author":"Omar","year":"2019","journal-title":"Eur Urol"},{"key":"B4","doi-asserted-by":"publisher","first-page":"97","DOI":"10.3390\/antiox10010097","article-title":"Oxidation of sperm DNA and male infertility","volume":"10","author":"Ghaleno","year":"2021","journal-title":"Antioxidants"},{"key":"B5","doi-asserted-by":"publisher","first-page":"523","DOI":"10.1038\/nrurol.2017.98","article-title":"Varicocele and male infertility","volume":"14","author":"Jensen","year":"2017","journal-title":"Nat Rev Urol"},{"key":"B6","doi-asserted-by":"publisher","first-page":"e13581","DOI":"10.1111\/and.13581","article-title":"Oxidative stress in the pathophysiology of male infertility","volume":"53","author":"Ritchie","year":"2020","journal-title":"Andrologia"},{"key":"B7","doi-asserted-by":"publisher","first-page":"225","DOI":"10.3109\/14647273.2015.1050462","article-title":"Oral antioxidant treatment partly improves integrity of human sperm DNA in infertile grade I varicocele patients","volume":"18","author":"Gual-Frau","year":"2015","journal-title":"Hum Fertil"},{"key":"B8","doi-asserted-by":"publisher","first-page":"e13179","DOI":"10.1111\/and.13179","article-title":"Berberine ameliorates experimental varicocele-induced damages at testis and sperm levels; evidences for oxidative stress and inflammation","volume":"51","author":"Hassani-Bafrani","year":"2018","journal-title":"Andrologia"},{"key":"B9","doi-asserted-by":"publisher","first-page":"6806","DOI":"10.1002\/fsn3.2632","article-title":"Lycopene protects sperm from oxidative stress in the experimental varicocele model","volume":"9","author":"Babaei","year":"2021","journal-title":"Food Sci Nutr"},{"key":"B10","doi-asserted-by":"publisher","first-page":"5445","DOI":"10.3390\/jcm14155445","article-title":"Recent trends in the management of varicocele","volume":"14","author":"Tak\u00e1cs","year":"2025","journal-title":"J Clin Med"},{"key":"B11","doi-asserted-by":"publisher","first-page":"6391","DOI":"10.3390\/jcm11216391","article-title":"The role and place of antioxidants in the treatment of male infertility caused by varicocele","volume":"11","author":"Szyma\u0144ski","year":"2022","journal-title":"J Clin Med"},{"key":"B12","doi-asserted-by":"publisher","first-page":"222","DOI":"10.4103\/1008-682X.171657","article-title":"An update on the role of medical treatment including antioxidant therapy in varicocele","volume":"18","author":"Kumar","year":"2016","journal-title":"Asian J Androl"},{"key":"B13","doi-asserted-by":"publisher","first-page":"523","DOI":"10.4081\/aiua.2020.3.263","article-title":"L-carnitine as primary or adjuvant treatment in infertile patients with varicocele. A systematic review","volume":"92","author":"Tsampoukas","year":"2020","journal-title":"Archivio Italiano Di Urologia E Andrologia"},{"key":"B14","doi-asserted-by":"publisher","first-page":"60","DOI":"10.5173\/ceju.2013.01.art19","article-title":"The role of oxidative stress and antioxidants in male fertility","volume":"65","author":"Walczak\u2013Jedrzejowska","year":"2013","journal-title":"Cent Eur J Urol"},{"key":"B15","doi-asserted-by":"publisher","first-page":"1973","DOI":"10.3892\/etm.2016.3569","article-title":"DNA methylation in spermatogenesis and male infertility","volume":"12","author":"Cui","year":"2016","journal-title":"Exp Ther Med"},{"key":"B16","doi-asserted-by":"publisher","first-page":"240","DOI":"10.1111\/and.12067","article-title":"Effect of folic acid and zinc sulphate on endocrine parameters and seminal antioxidant level after varicocelectomy","volume":"46","author":"Nematollahi-Mahani","year":"2013","journal-title":"Andrologia"},{"key":"B17","doi-asserted-by":"publisher","first-page":"IE01","DOI":"10.7860\/JCDR\/2017\/23927.9886","article-title":"The impact of oxidative stress on testicular function and the role of antioxidants in improving it: a review","volume":"11","author":"Asadi","year":"2017","journal-title":"J Clin Diagn Res"},{"key":"B18","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1093\/oxfordjournals.aje.a114086","article-title":"Reproducibility and validity of a semiquantitative food frequency questionnaire","volume":"122","author":"Willett","year":"1985","journal-title":"Am J Epidemiol"},{"key":"B19","doi-asserted-by":"publisher","first-page":"243","DOI":"10.1093\/ajcn\/69.2.243","article-title":"Reproducibility and validity of dietary patterns assessed with a food-frequency questionnaire","volume":"69","author":"Hu","year":"1999","journal-title":"Am J Clin Nutr"},{"key":"B20","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1186\/s12610-023-00197-9","article-title":"Micronutrient supplements as antioxidants in improving sperm quality and reducing DNA fragmentation","volume":"33","author":"Nguyen","year":"2023","journal-title":"Basic Clin Androl"},{"key":"B21","doi-asserted-by":"publisher","first-page":"e12927","DOI":"10.1111\/and.12927","article-title":"Effect of metabolic and antioxidant supplementation on sperm parameters in oligo-astheno-teratozoospermia, with and without varicocele: a double-blind placebo-controlled study","volume":"50","author":"Busetto","year":"2018","journal-title":"Andrologia"},{"key":"B22","doi-asserted-by":"publisher","first-page":"7870","DOI":"10.3390\/ijms21217870","article-title":"Coenzyme Q10 supplementation for the reduction of oxidative stress: clinical implications in the treatment of chronic diseases","volume":"21","author":"Gutierrez-Mariscal","year":"2020","journal-title":"Int J Mol Sci"},{"key":"B23","doi-asserted-by":"publisher","first-page":"49","DOI":"10.5653\/cerm.2021.04910","article-title":"Comparison of the effects of coenzyme Q10 and Centrum multivitamins on semen parameters, oxidative stress markers, and sperm DNA fragmentation in infertile men with idiopathic oligoasthenospermia","volume":"49","author":"Alahmar","year":"2022","journal-title":"Daehan Saengsik Uihak Hoeji\/Clin Exp Reprod Med"},{"key":"B24","doi-asserted-by":"publisher","first-page":"874","DOI":"10.3390\/antiox10060874","article-title":"Coenzyme Q10 and male infertility: a systematic review","volume":"10","author":"Salvio","year":"2021","journal-title":"Antioxidants"},{"key":"B25","doi-asserted-by":"publisher","first-page":"1807","DOI":"10.5534\/wjmh.250159","article-title":"Efficacy and safety of coenzyme Q10 in idiopathic male infertility: a systematic review and meta-analysis of randomized trials","volume":"43","author":"Bakri","year":"2025","journal-title":"World J Men Health"},{"key":"B26","doi-asserted-by":"publisher","first-page":"829","DOI":"10.1111\/and.12521","article-title":"The impact of vitamin E supplementation on semen parameters and pregnancy rates after varicocelectomy: a randomised controlled study","volume":"48","author":"Ener","year":"2016","journal-title":"Andrologia"},{"key":"B27","doi-asserted-by":"publisher","first-page":"36","DOI":"10.1186\/s13063-025-08740-x","article-title":"The impact of vitamin E supplementation on sperm analysis in varicocelectomy patients: a triple-blind randomized controlled trial","volume":"26","author":"Saeedian","year":"2025","journal-title":"Trials"},{"key":"B28","doi-asserted-by":"publisher","first-page":"810242","DOI":"10.3389\/fendo.2022.810242","article-title":"The effect of antioxidants on sperm quality parameters and pregnancy rates for idiopathic male infertility: a network meta-analysis of randomized controlled trials","volume":"13","author":"Li","year":"2022","journal-title":"Front Endocrinol"},{"key":"B29","doi-asserted-by":"publisher","first-page":"47","DOI":"10.5653\/cerm.2024.07493","article-title":"Varicocelectomy versus antioxidants in infertile men with isolated teratozoospermia: a randomized controlled trial","volume":"53","author":"Saber-Khalaf","year":"2025","journal-title":"Daehan Saengsik Uihak Hoeji\/Clin Exp Reprod Med"},{"key":"B30","doi-asserted-by":"publisher","first-page":"601","DOI":"10.1016\/j.eururo.2025.02.026","article-title":"European association of urology guidelines on male sexual and reproductive health: 2025 update on male infertility","volume":"87","author":"Minhas","year":"2025","journal-title":"Eur Urol"}],"container-title":["Frontiers in Nutrition"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnut.2026.1838102\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T14:46:08Z","timestamp":1781534768000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnut.2026.1838102\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,15]]},"references-count":30,"alternative-id":["10.3389\/fnut.2026.1838102"],"URL":"https:\/\/doi.org\/10.3389\/fnut.2026.1838102","relation":{},"ISSN":["2296-861X"],"issn-type":[{"value":"2296-861X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,15]]},"article-number":"1838102"}}