Мужское бесплодие при оксидативном стрессе: пути решения проблемы


DOI: https://dx.doi.org/10.18565/urology.2022.1.102-108

И.А. Корнеев

ФГБОУ ВО «Первый Санкт-Петербургский государственный медицинский университет им. академика И. П. Павлова» Министерства здравоохранения Российской Федерации, Санкт-Петербург, Россия
В статье проведен обзор исследований, подтверждающих распространенность мужского бесплодия, связанного с оксидативным стрессом, а также заболеваний и факторов образа жизни и внешней среды, способствующих усилению окислительных процессов и снижающих фертильность мужчин. Представлено описание эндогенных и экзогенных факторов защитной антиоксидантной системы организма и сведения, подтверждающие, что применение препаратов с антиоксидантными свойствами, содержащих β-каротин, витамины E и C, а также микронутриенты селен и цинк, у мужчин с бесплодием, связанным с оксидативным стрессом, позволяет нормализовать содержание активных форм кислорода в эякуляте, улучшить его показатели и повысить вероятность зачатия.

Литература


1. Levine H., Jorgensen N., Martino-Andrade A., et al. Temporal trends in sperm count: a systematic review and meta-regression analysis. Hum. Reprod. Update. 2017,23(6):646–659. Doi: 10.1093/humupd/dmx022


2. Lebedev G.S., Golubev N.A., Shaderkin I.A., et al. Male infertility in the Russian Federation: statistical data for 2000–2018. Experimental and clinical urology.2019;4:4–13. Russian (Лебедев Г.С., Голубев Н.А., Шадеркин И.А. и др. Мужское бесплодие в Российской Федерации: статистические данные за 2000–2018 годы. Экспериментальная и клиническая урология. 2019;4:4–13). Doi: 10.29188/2222-8543-2019-11-4-4-12.


3. Kothandaraman N., Agarwal A., Abu-Elmagd M., Al-Qahtani M.H. Pathogenic landscape of idiopathic male infertility: new insight towards its regulatory networks. NPJ.Genom.Med. 2016.17(1):16023. Doi: 10.1038/npjgenmed.2016.23. PMID.


4. World Health Organization.WHO LaboratoryManual for the Examination and Processing of Human Semen, 6th ed.;WHO Press: Geneva, Switzerland, 2021. Available online: https://www.who.int/publications/i/item/9789240030787


5. Agarwal A., Parekh N., Panner Selvam M.K., 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(3):296–312.


6. Agarwal A., Panner Selvam M.K., Arafa M.et al. Multi-center evaluation of oxidation-reduction potential by the MiOXSYS in males with abnormal semen. Asian. J. Androl. 2019;21(6):565-569. Doi: 10.4103/aja.aja_5_19.


7. Agarwal A., Panner Selvam M.K., Leisegang K. et al. A Global Survey of Reproductive Specialists to Determine the Clinical Utility of Oxidative Stress Testing and Antioxidant Use in Male Infertility. World J. Mens. Health. 2021;39(3):470–488.


8. Cissen M., Wely M.V., Scholten I., et al. Measuring Sperm DNA Fragmentation and Clinical Outcomes of Medically Assisted Reproduction: A Systematic Review and Meta-Analysis. PLoS One. 2016;10;11(11):e0165125. Doi: 10.1371/journal.pone.0165125.


9. Oleszczuk K., Giwercman A., Bungum M. Intra-individual variation of the sperm chromatin structure assay DNA fragmentation index in men from infertile couples. Hum. Reprod. 2011;26(12):3244–3248. Doi: 10.1093/humrep/der328. Epub 2011 Oct 6.


10. Barbagallo F., Condorelli R.A., Mongioì L.M., et al. Molecular Mechanisms Underlying the Relationship between Obesity and Male Infertility. Metabolites. 2021;4;11(12):840. Doi: 10.3390/metabo11120840.


11. Tunc O., Bakos H.W., Tremellen K. Impact of body mass index on seminal oxidative stress. Andrologia 2011;43:121–128.


12. Korneyev I.A., Matsueva I.A. Male infertility, metabolic syndrome and obesity. Urology reports. 2021;11(2).153-162. Russian (Корнеев И.А., Мацуева И.А. Мужское бесплодие, метаболический синдром и ожирение. Урологические ведомости. 2021;11(2):153–162). Doi:10.17816/uroved61509.


13. Sallmén M., Sandler D.P., Hoppin J.A., et al. Reduced fertility among overweight and obese men. Epidemiol. Camb. Mass. 2006;17(5):520–523. Doi: 10.1097/01.ede.0000229953.76862.e5.


14. Epanchintseva E.A., Selyatitskaya V.G., Sviridova M.A., Lutov Yu.V. Sociomedical risk factors for male infecundity. Andrology and Genital Surgery. 2016;17(3):47–53. Russian (Епанчинцева Е.А., Селятицкая В.Г., Свиридова М.А., Лутов Ю.В. Медико-социальные факторы риска бесплодия у мужчин. Андрология и генитальная хирургия. 2016;17(3):47–53). Doi: 10.17650/2070-9781-2016-17-3-47-53.


15. Mir J., Franken D., Andrabi S.W., et al. Impact of weight loss on sperm DNA integrity in obese men. Andrologia. 2018(1). Doi: 10.1111/and.12957.


16. Agarwal A., Prabakaran S., Allamaneni S.S. Relationship between oxidative stress, varicocele and infertility: a meta-analysis. Reprod. Biomed. Online. 2006;12(5):630–633. Doi: 10.1016/s1472-6483(10)61190-x.


17. Smit M., Romijn J.C., Wildhagen M.F., et al. Decreased sperm DNA fragmentation after surgical varicocelectomy is associated with increased pregnancy rate. J. Urol. 2013;189(1 Suppl):S146–150. Doi:10.1016/j.juro.2012.11.024.


18. Chen S.S., Huang WJ, Chang LS, Wei YH. Attenuation of oxidative stress after varicocelectomy in subfertile patients with varicocele. J. Urol. 2008;179(2):639–642. Doi: 10.1016/j.juro.2007.09.039.


19. Wolff H. The biologic significance of white blood cells in semen. Fertil. Steril. 1995; 63(6):1143–1157. Doi: 10.1016/s0015-0282(16)57588-8.


20. Esteves S.C. Effect of cigarette smoking on levels of seminal oxidative stress in infertile men: a prospective study. Int. Braz. J. Urol. 2002;28(5):484–485.


21. Maneesh M., Dutta S., Chakrabarti A., Vasudevan D.M.. Alcohol abuse-duration dependent decrease in plasma testosterone and antioxidants in males. Indian J. Physiol. Pharmacol. 2006;50:291–296.


22. Cocuzza M., Athayde K.S., Agarwal A., et al. Age-Related Increase of Reactive Oxygen Species in Neat Semen in Healthy Fertile Men. Urology. 2008;71:490–494. Doi: 10.1016/j.urology.2007.11.041.


23. Mahfouz R., Sharma R., Thiyagarajan A., et al. Semen characteristics and sperm DNA fragmentation in infertile men with low and high levels of seminal reactive oxygen species. Fertil. Steril. 2010;94:2141–2146. Doi: 10.1016/j.fertnstert.2009.12.030.


24. Comments on clinical guidelines. Urology. Ed. Pushkar D.Y., ID ABV-press, 2020, 500 p. Russian (Комментарии к клиническим рекомендациям. Урология. Под ред. Д.Ю.Пушкаря. М.: «ИД «АБВ-пресс», 2020. 500 с.)


25. Korneyev I.A., Zasseev R.D., Shevchuk I.G., Pelipejchenko A.A. Prevalence of sexually transmitted diseases among men from infertile couples. Urology reports. 2018;8(2):30–35. Russian (Корнеев И.А., Зассеев Р.Д., Шевчук И.Г., Пелипейченко А.А. Распространенность инфекций, передающихся половым путем, у мужчин, состоящих в бесплодном браке. Урологические ведомости. 2018;8(2):30–35. Doi:10.17816/uroved8230–8235/


26. Hamada A., Agarwal A., Sharma R., et al. Empirical treatment of low-level leukocytospermia with doxycycline in male infertility patients. Urology. 2011.78(6):1320–1325. Doi: 10.1016/j.urology.2011.08.062.


27. Serafini F., Campanella G., Morgante G., et al. Sperm quality improvement after natural anti-oxidant treatment of asthenoteratospermic men with leukocytospermia. Asian J. Androl. 2008;10(2):201–206. Doi:10.1111/j.1745-7262.2008.00356.x.


28. Jung J.H., Kim M.H., Kim J., et al. Treatment of leukocytospermia in male infertility: a systematic review. World J. Mens Health 2016;34:165–172. Doi: 10.5534/wjmh.2016.34.3.165.


29. Degirmenci Y., Demirdag E., Guler I., et al. Impact of the sexual abstinence period on the production of seminal reactive oxygen species in patients undergoing intrauterine insemination: A randomized trial. J.Obstet.Gynaecol.Res. 2020;46(7):1133–1139. Doi: 10.1111/jog.14308.


30. Comar V.A., Petersen C.G., Mauri A.L., et al. Influence of the abstinence period on human sperm quality: analysis of 2,458 semen samples. JBRA Assist. Reprod. 2017;1;21(4):306–312. Doi: 10.5935/1518-0557.20170052.


31. Hanson B.M., Aston K.I., Jenkins T.G., et al. The impact of ejaculatory abstinence on semen analysis parameters: a systematic review. J.Assist.Reprod.Genet. 2018;35(2):213–220. Doi: 10.1007/s10815-017-1086-0.


32. Sokol P., Drakopoulos P., Polyzos N.P. The Effect of Ejaculatory Abstinence Interval on Sperm Parameters and Clinical Outcome of ART. A Systematic Review of the Literature. J. Clin. Med. 2021;21;10(15):3213. Doi: 10.3390/jcm10153213. PMID: 34361997.


33. Shen Z.Q., Shi B., Wang T.R., et al. Characterization of the Sperm Proteome and Reproductive Outcomes with in Vitro, Fertilization after a Reduction in Male Ejaculatory Abstinence Period. Mol.Cell Proteomics. 2019;15;18(Suppl 1):S109–S117. Doi: 10.1074/mcp.RA117.000541.


34. Bonde J.P. Male reproductive organs are at risk from environmental hazards. Asian J. Androl. 2010;12(2):152–156. Doi: 10.1038/aja.2009.83.


35. Wdowiak A., Skrzypek M., Stec M., Panasiuk L. Effect of ionizing radiation on the male reproductive system. Ann. Agric. Environ. Med. 2019;17;26(2):210–216. Doi: 10.26444/aaem/106085.


36. Schrader S.M., Marlow K.L. Assessing the reproductive health of men with occupational exposures. Asian J. Androl. 2014;16(1):23–30. Doi: 10.4103/1008-682X.122352.


37. Jamalan M., Ghaffari M.A., Hoseinzadeh P., et al. Human Sperm Quality and Metal Toxicants: Protective Effects of some Flavonoids on Male Reproductive Function. Int. J. Fertil. Steril. 2016;10(2):215–223. Doi:10.22074/ijfs.2016.4912.


38. Ivell R. Lifestyle impact and the biology of the human scrotum. Reprod. Biol. Endocrinol. 2007;20(5):15. Doi: 10.1186/1477-7827-5-15.


39. Rao M., Zhao X-L., Yang J., et al. Effect of transient scrotal hyperthermia on sperm parameters, seminal plasma biochemical markers, and oxidative stress in men. Asian J. Androl. 2015;17(4):668–675. Doi: 10.4103/1008-682X.146967.


40. Bedford J.M. Effects of elevated temperature on the epididymis and testis: experimental studies. Adv. Exp. Med. Biol. 1991;286:19–32. Doi: 10.1007/978-1-4684-5913-5_3.


41. Nikolopoulos I., Osman W., Haoula Z., et al. Scrotal cooling and its benefits to male fertility: a systematic review. J. Obstet. Gynaecol. 2013;33(4):338–342. Doi: 10.3109/01443615.2012.758088.


42. Fratta Pasini A.M., Stranieri C., Cominacini L., Mozzini C. Potential Role of Antioxidant and Anti-Inflammatory Therapies to Prevent Severe SARS-Cov-2 Complications. Antioxidants (Basel) 2021;10(2):272. Doi: 10.3390/antiox10020272.


43. Dama M.S., Bhat M.N. Mobile phones affect multiple sperm quality traits: a meta-analysis. F1000Res. 2013;12(2):40. Doi: 10.12688/f1000research.2-40.v1. PMID:.


44. Agarwal A., Deepinder F., Sharma R.K., et al. Effect of cell phone usage on semen analysis in men attending infertility clinic: an observational study. Fertil Steril. 2008;89(1):124–128. Doi: 10.1016/j.fertnstert.2007.01.166.


45. Avendaño C., Mata A., Sanchez Sarmiento C.A., Doncel G.F. Use of laptop computers connected to internet through Wi-Fi decreases human sperm motility and increases sperm DNA fragmentation. Fertil. Steril. 2012;97(1):39–45.e2. Doi: 10.1016/j.fertnstert.2011.10.012


46. Harlev A., Agarwal A., Gunes S.O., et al. Smoking and Male Infertility: An Evidence-Based Review. World J. Mens Health. 2015;33(3):143–160. Doi: 10.5534/wjmh.2015.33.3.143.


47. Martins A.D., Agarwal A. Oxidation reduction potential: a new biomarker of male infertility. Panminerva Med. 2019;61(2):108–117. Doi: 10.23736/S0031-0808.18.03529-2.


48. Leisegang K., Dutta S. Do lifestyle practices impede male fertility? Andrologia. 2021;53(1):e13595. Doi: 10.1111/and.13595.


49. Close C.E., Roberts P.L., Berger R.E. Cigarettes, alcohol and marijuana are related to pyospermia in infertile men. J.Urol. 1990;144(4):900–903. Doi: 10.1016/s0022-5347(17)39618-0.


50. Dawson E.B., Harris W.A., Teter M.C., Powell L.C. Effect of ascorbic acid supplementation on the sperm quality of smokers. Fertil. Steril. 1992;58(5):1034–1039.


51. Prentki Santos E., López-Costa S., Chenlo P., et al. Impact of spontaneous smoking cessation on sperm quality: case report. Andrologia. 2011;43(6):431–435. Doi: 10.1111/j.1439-0272.2010.01089.


52. Emanuele M.A., Emanuele N.V. Alcohol’s effects on male reproduction. Alcohol Health Res World. 1998;22(3):195–201.


53. Walczak-Jedrzejowska R., Wolski J.K., Slowikowska-Hilczer J. The role of oxidative stress and antioxidants in male fertility. Cent. European. J. Urol. 2013;66(1):60-67. Doi: 10.5173/ceju.2013.01.art19.


54. Smits R.M., Mackenzie-Proctor R., Yazdani A., et al. Antioxidants for male subfertility. Cochrane Database Syst.Rev. 2019;14;3(3):CD007411. Doi: 10.1002/14651858.CD007411.pub4.


55. Al-Azemi M.K., Omu A.E., Fatinikun T., et al. Factors contributing to gender differences in serum retinol and alpha-tocopherol in infertile couples. Reprod Biomed Online. 2009;19(4):583–590. Doi:10.1016/j.rbmo.2009.05.005.


56. Maya-Soriano M.J., Taberner E., Sabés-Alsina M., López-Béjar M. Retinol might stabilize sperm acrosomal membrane in situations of oxidative stress because of high temperatures. Theriogenology. 2013;79(2):367–373. Doi: 10.1016/j.theriogenology.2012.10.009.


57. Calogero A.E., Condorelli R.A., Russo G.I., La Vignera S. Conservative Nonhormonal Options for the Treatment of Male Infertility: Antibiotics, Anti-Inflammatory Drugs, and Antioxidants. Biomed. Res. Int. 2017;2017:4650182. Doi: 10.1155/2017/4650182.


58. Jacob R.A., Pianalto F.S., Agee R.E. Cellular ascorbate depletion in healthy men. J.Nutr. 1992;122(5):1111–1118. Doi: 10.1093/jn/122.5.1111.


59. Thiele J.J., Friesleben H.J., Fuchs J., Ochsendorf F.R. Ascorbic acid and urate in human seminal plasma: determination and interrelationships with chemiluminescence in washed semen. Hum Reprod.1995;10(1):110–115. Doi: 10.1093/humrep/10.1.110. PMID: 7745037.


60. Song G.J., Norkus E.P., Lewis V. Relationship between seminal ascorbic acid and sperm DNA integrity in infertile men. Int. J. Androl. 2006;29(6):569–575. Doi: 10.1111/j.1365-2605.2006.00700.x


61. Eskenazi B., Kidd S.A., Marks A.R., et al. Antioxidant intake is associated with semen quality in healthy men. Hum. Reprod. 2005;20(4):1006–1012. Doi: 10.1093/humrep/deh725.


62. Thérond P., Auger J., Legrand A., Jouannet P. alpha-Tocopherol in human spermatozoa and seminal plasma: relationships with motility, antioxidant enzymes and leukocytes. Mol.Hum.Reprod. 1996;2(10):739–744. Doi: 10.1093/molehr/2.10.739. PMID: 9239691.


63. Kessopoulou E., Powers H.J., Sharma K.K., et al. A double-blind randomized placebo cross-over controlled trial using the antioxidant vitamin E to treat reactive oxygen species associated male infertility. Fertil. Steril. 1995;64(4):825–831. Doi: 10.1016/s0015-0282(16)57861-3.


64. Suleiman S.A., Ali M.E., Zaki Z.M., et al. Lipid peroxidation and human sperm motility: protective role of vitamin E. J.Androl. 1996;17(5):530–537.


65. Geva E., Bartoov B., Zabludovsky N., et al. The effect of antioxidant treatment on human spermatozoa and fertilization rate in an in vitro fertilization program. Fertil. Steril. 1996;66(3):430–434. Doi: 10.1016/s0015-0282(16)58514-8.


66. Choi S., Liu X., Pan Z. Zinc deficiency and cellular oxidative stress: Prognostic implications in cardiovascular diseases. Acta Pharmacol. Sin. 2018;39:1120–1132. Doi: 10.1038/aps.2018.25.


67. Nadjarzadeh A., Mehrsai A., Mostafavi E., et al. The association between dietary antioxidant intake and semen quality in infertile men. Med. J. Islamic Repub. Iran 2013;27:204–209.


68. Fallah A., Mohammad-Hasani A., Colagar A.H. Zinc is an essential element for male fertility: A review of Zn roles in men’s health, germination, sperm quality, and fertilization. J. Reprod. Infertil. 2018;19:69–81.


69. Prasad A.S. Trace metals in growth and sexual maturation. In Metabolism of Trace Metals in Man Volume I (1984): Developmental Aspects; CRC Press: New York, N.Y., USA, 2017


70. Mirnamniha M., Faroughi F., Tahmasbpour E., et al. An overview on role of some trace elements in human reproductive health, sperm function and fertilization process. Rev. Environ. Health 2019;34:339–348. Doi: 10.1515/reveh-2019-0008.


71. Zhao J., Dong X., Hu X., et al. Zinc levels in seminal plasma and their correlation with male infertility: A systematic review and meta-analysis. Sci.Rep. 2016;6:22386. Doi: 10.1038/srep22386.


72. Oldereid N.B., Thomassen Y., Purvis K. Selenium in human male reproductive organs. Hum Reprod 1998;13:2172– 2176. Doi: 10.1093/humrep/13.8.2172.


73. Eroglu M., Sahin S., Durukan B., et al. Blood serum and seminal plasma selenium, total antioxidant capacity and coenzyme q10 levels in relation to semen parameters in men with idiopathic infertility. Biol. Trace Elem. Res. 2014;159:46–51. Doi: 10.1007/s12011-014-9978-7.


74. Omar M.I., Pal R.P., Kelly B.D., et al. 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. Eur.Urol. 2019;75(4):615–625. Doi: 10.1016/j.eururo.2018.12.022.


75. Neymark A.I., Klepikova I.I. Use of the drug Selzinc plus in men with impaired fertility. Andrology and genital surgery. 2013;4:77–80. Russian (Неймарк А.И., Клепикова И.И. Применение препарата Селцинк плюс у мужчин с нарушением фертильности. Андрология и генитальная хирургия 2013;4:77–80).


76. Sivkov A.V., Oshepkov V.N., Evdokimov V.V. et al. Efficacy and safety of the drug Selzinc plus in patients with chronic abacterial prostatitis and impaired fertility. Consilium Medicum. 2011;13(7):5–9. Russian (Сивков А.В., Ощепков В.Н., Евдокимов В.В. и др. Эффективность и безопасность препарата Селцинк Плюс у пациентов с хроническим неинфекционным простатитом и нарушениями фертильности Consilium Medicum. 2011;13(7):5–9).


77. Kulchavenya E.V., Osadchiy A.V. The effectiveness of therapy based on sperm-protective Selzinc plus in patients with tuberculosis of the prostate. Consilium Medicum. 2016; 18 (7): 22–26. Russian (Кульчавеня Е.В., Осадчий А.В. Эффективность сперматопротективной терапии на основе Селцинка плюс у больных туберкулезом предстательной железы. Consilium Medicum. 2016; 18 (7): 22–26). Doi: 10.26442/2075-1753_2016.7.22-26


Об авторах / Для корреспонденции


А в т о р д л я с в я з и: И. А. Корнеев – д.м.н., профессор, кафедра урологии ПСПбГМУ им. акад. И. П. Павлова, e-mail: iakorneyev@yandex.ru


Похожие статьи


Бионика Медиа