Endocrine Abstracts

Introduction: Although the pathogenic mechanism is not completely understood, pharmacological treatments could negatively affect seminal parameters. The analysis of inflammatory (i.e. cytokines) and oxidative stress parameters represent a new tools to investigate the causes of idiopathic male infertility. The aim of this study was to evaluate the impact of medications on oxidative stress, inflammatory parameters and semen characteristics in male with idiopathic infertility.

Materials and Methods: In this observational, case-control, clinical study 50 men with idiopathic infertility, referring to the Endocrinology-Andrology Unit of Sant’Andrea Hospital – ‘Sapienza’ University of Rome, from October 2017 to June 2018 were enrolled. Of them, 38 subjects (study group) were on pharmacological treatment from at least three months and 12 subjects were enrolled as a control. The study group were clustered according to the medications (Group A: anti-hypertensive, n.10; Group B: thyroxine, n.6; Group C: chronic anti-inflammatory, n.13; Group D: miscellaneous, n.6; Group E: lipid-lowering agents, n.4). Semen analysis were performed according to WHO 2010 guideline. Interleukins (IL)-10, IL-1beta, IL-4 as anti-inflammatory cytokines, IL-6, TNF-alpha as pro-inflammatory, and IL-1alpha, as a marker of testicular function, were determined using a solid phase sandwich immunoassay. The d-ROM test was assessed through a colorimetric determination of reactive oxygen metabolites and measured by a spectrophotometer. Beta-2-Microglobulin and Cystatin-C, were measured with an immunoturbidimetric analyzer.

Results: No difference between study and control group for age and macroscopic and microscopic semen characteristics were found. The same result was obtained after clustering and comparing the study group according to the drug categories. IL-1 alpha and IL-10 were significantly lower in the study group compared to control. After clustering the study group, IL-10 was significantly lower in groups A, B, C and D compared to control group. Furthermore, a direct correlation between IL- 1alpha, IL-10 and TNF-alpha and leukocytes was found. Conversely, a statistically significant inverse correlation between IL-4 and sperm concentration, and between beta-2 Microglobulin and total sperm number were highlighted.

Conclusions: This study represents a first attempt to understand how drugs belonging to different categories could affect the properties of semen. Although the sample size was not large, the data suggests a correlation between the use of medications and inflammation. This could clarify the pathogenic mechanism of action for several pharmacological classes on male infertility, which is not completely known. Further studies on larger populations are needed to investigate the possible role of the various drug categories on male fertility.