Русский
Treatment of infertility in men with pathospermia associated with oxidative stress
DOI: https://dx.doi.org/10.18565/urology.2023.2.73-79
I.V. Vinogradov, M.Yu. Gablia, D.S. Rogozin, O.H. Tazhetdinov, E.G. Novikova, D.M. Fateev, Yu.V. Olefir, G.M.V. Estevesh
1) Department of Urology and Operative Nephrology with a course of oncourology, Peoples’ Friendship University of Russia, Moscow, Russia; 2) Scientific and Practical Center of Reproductive and Regenerative Medicine, Moscow, Russia; 3) South Ural State Medical University, Department of General and Pediatric surgery, Chelyabinsk, Russia; 4) Krasnodar Medical and Biological Center Ltd, Krasnodar, Russia; 5) Regional Medical Diagnostic Center, Novosibirsk, Russia; 6) Federal Research Center for Fundamental and Translational Medicine, Novosibirsk, Russia; 7) Medical Center for Diagnostics and Prevention Plus, Yaroslavl, Russia; 8) I.M. Sechenov First Moscow State Medical University, Moscow, Russia
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.
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.
About the Autors
Corresponding author: Vinogradov I.V. – Ph.D., MD, professor of the Department of Urology and Operative Nephrology with a course of oncourology, Peoples’ Friendship University of Russia, Moscow, Russia, e-mail: ivvinogradov@mail.ru
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