Treatment of infertility in men with pathospermia associated with oxidative stress
- Authors: Vinogradov V.I.1,2, Gabliya M.Y.2, Rogozin D.S.3, Tazhetdinov O.H.4, Novikova E.G.5,6, Fateev D.M.7, Olefir Y.V.8, Estevesh G.M.1
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Affiliations:
- Peoples’ Friendship University of Russia
- Scientific and Practical Center of Reproductive and Regenerative Medicine
- South Ural State Medical University
- Krasnodar Medical and Biological Center Ltd
- Regional Medical Diagnostic Center
- Federal Research Center for Fundamental and Translational Medicine
- Medical Center for Diagnostics and Prevention Plus
- I.M. Sechenov First Moscow State Medical University
- Issue: No 2 (2023)
- Pages: 73-79
- Section: Original Articles
- URL: https://journals.eco-vector.com/1728-2985/article/view/523018
- DOI: https://doi.org/10.18565/urology.2023.2.73-79
- ID: 523018
Cite item
Abstract
Introduction. Oxidative stress considered to be the main cause of male infertility. Surgical treatment of varicocele and elimination of the inflammatory process in the male accessory glands can help reduce the level of oxidative stress, however, in most cases, antioxidant therapy is additionally prescribed. Currently, much attention is paid to regulatory peptides as a component of antioxidant therapy due to their antioxidant, anti-inflammatory and immunomodulatory properties.
Aim. To evaluate the efficiency of a complex of antimicrobial peptides and cytokines Superlymph® for the treatment of male infertility associated with oxidative stress.
Materials and methods. A total of 30 patients with elevated levels of reactive oxygen species were recruited in the open, prospective, multicenter study. Ejaculate analysis (WHO-2010), MAR-test, sperm DNA damage testing and reactive oxygen species measurement were performed. All patients received Superlymph® 25 IU/day for 60 days. Antibiotics and vitamin D were also prescribed if indicated. In addition, 12 patients took dietary supplements with antioxidant action. Laboratory tests were repeated after the completion of treatment.
Results. Superlymph® therapy led to an improvement in standard semen parameters as well as decrease in sperm DNA fragmentation and oxidative stress. At the end of treatment, a significant increase in the sperm concentration was observed (46.8 [30; 87] vs. 62 [43–89], p=0.002). After treatment, there was also an increase in the median of sperm cells with normal morphology (3 [1; 7] vs. 4.5 [2; 9], p=0.002). The median sperm DNA fragmentation was lower compared to baseline, but this difference did not reach significant level (19 [14; 26] vs. 15 [10.5; 19.5], p=0.06). A significant decrease in the level of oxidative stress both in patients who took Superlymph® as monotherapy (43 [27; 51] vs. 33 [22; 44], p=0.005), and as part of combination therapy with other antioxidants (31 [22; 54] vs. 21 [12; 36], p=0.009) was also observed.
Conclusion. Superlymph® contributes to the improvement of standard ejaculate parameters as well as decrease in the level of sperm DNA fragmentation and oxidative stress.
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About the authors
V. I. Vinogradov
Peoples’ Friendship University of Russia; Scientific and Practical Center of Reproductive and Regenerative Medicine
Author for correspondence.
Email: ivvinogradov@mail.ru
ORCID iD: 0000-0001-7469-3952
Ph.D., MD, professor of the Department of Urology and Operative Nephrology with a course of oncourology
Russian Federation, Moscow; MoscowM. Yu. Gabliya
Scientific and Practical Center of Reproductive and Regenerative Medicine
Email: ivvinogradov@mail.ru
ORCID iD: 0000-0002-8176-2597
andrologist
Russian Federation, MoscowD. S. Rogozin
South Ural State Medical University
Email: ivvinogradov@mail.ru
Ph.D., Department of General and Pediatric surgery
Russian Federation, ChelyabinskO. H. Tazhetdinov
Krasnodar Medical and Biological Center Ltd
Email: ivvinogradov@mail.ru
ORCID iD: 0000-0001-6162-1554
Ph.D.
Russian Federation, KrasnodarE. G. Novikova
Regional Medical Diagnostic Center; Federal Research Center for Fundamental and Translational Medicine
Email: ivvinogradov@mail.ru
ORCID iD: 0000-0003-4723-0666
Ph.D., Chief researcher of the Endocrinologic Laboratory; urologist and andrologist
Russian Federation, Novosibirsk; NovosibirskD. M. Fateev
Medical Center for Diagnostics and Prevention Plus
Email: ivvinogradov@mail.ru
Ph.D., urologist and andrologist
Russian Federation, YaroslavlYu. V. Olefir
I.M. Sechenov First Moscow State Medical University
Email: ivvinogradov@mail.ru
ORCID iD: 0000-0001-7652-4642
Ph.D., MD, professor
Russian Federation, MoscowG. M.V. Estevesh
Peoples’ Friendship University of Russia
Email: ivvinogradov@mail.ru
ORCID iD: 0000-0002-0830-6405
Ph.D. student of the Department of Urology and Operative Nephrology with a course of oncourology
Russian Federation, MoscowReferences
- World Health Organization (WHO) WHO laboratory manual for the examination and processing of human semen, sixth edition. Geneva: World Health Organization; 2021.
- Agarwal A., Parekh N., Panner Selvam M.K., Henkel R., Shah R., Homa S.T., et al. Male oxidative stress infertility (MOSI): proposed terminology and clinical practice guidelines for management of idiopathic male infertility. World J Mens Health. 2019;37:296–312.
- Dutta S., Majzoub A., Agarwal A. Oxidative stress and sperm function: A systematic review on evaluation and management. Arab J Urol. 2019 Apr 24;17(2):8797. doi: 10.1080/2090598X.2019.1599624. PMID: 31285919; PMCID: PMC6600059.
- Beygi Z., Forouhari S., Mahmoudi E., Hayat S.M.G., Nourimand F. Role of Oxidative Stress and Antioxidant Supplementation in Male Fertility. Curr Mol Med. 2021;21(4):265–282. doi: 10.2174/1566524020999200831123553. PMID: 32867638.
- Male Infertility Gudeline EAU 2022.
- Zaitsev V.G., Ostrovsky O.V., Zakrevsky V.I. The relationship between the chemical structure and the target of action, as the basis for the classification of direct-acting antioxidants. Experimental clinical pharmacology. 2003;66(4):66–70.
- Male infertility. Clinical recommendations of the Russian Federation, 2021.
- Pushkar D.Yu., Kupriyanov Yu.A., Bernikov A.N., Gamidov S.I., etc. Evaluation of the safety and efficacy of the drug based on regulatory polypeptides of testes PPR-001. Urologiia. 2021;6:100–108.
- Tyuzikov I.A., Grekov E.A., Smirnov A.V. Local cytokinotherapy in the complex treatment of chronic prostatitis. Effective pharmacotherapy. 2022;3:26–38.