Probiotics Outperform Antioxidants in Improving Semen Parameters of Men with Idiopathic Oligoasthenoteratozoospermia: A Randomized Controlled Trial.

Background: Idiopathic oligoasthenoteratozoospermia (iOAT) treatment still poses significant challenges. This study aims to compare the therapeutic efficacy of probiotics on sperm parameters of iOAT patients with placebo and antioxidants. Methods: ), or a placebo daily for 3 months, in two academic centers in Iran (Isfahan and Yazd). The study was conducted from July 2021 to April 2022. Sperm parameters were analyzed using computer-assisted semen analysis. The main measured outcomes included semen volume and sperm features, including motility, morphology, and concentration. Changes in semen parameters were assessed using linear mixed-effects models with fixed effects for time, group, and their interaction. Estimated marginal means were compared across groups using Bonferroni-adjusted pairwise tests. Results: /mL, P=0.007), motility (46.65±3.73%, P=0.001), and morphology (4.31±0.21%, P