ABSTRACT
INTRODUCTION: Chronic prostatitis (CP) has long been considered one of the common causes of male infertility. The influence of therapy for CP on spermatogenesis is well studied. However, recently, especially in the era of the new coronavirus infection (COVID-19), much attention has been paid to the effects of cytokines on the pathogenesis of the inflammatory process, and their impact on male fertility. AIM: To study the effect of a complex of natural antimicrobial peptides and cytokines (Superlymph) on ejaculate, MAR test, oxidative stress (OS), and sperm DNA fragmentation (SDF) in men with infertility and a history of CP. In some patients, the level of cytokines before and after treatment was determined. MATERIALS AND METHODS: A total of 583 infertile men with a history of CP, aged 18-75 years, were screened according to the inclusion/ exclusion criteria. In group I, patients received antioxidant stimulation of spermatogenesis (triovit, trental, mexidol) in combination with a complex of natural antimicrobial peptides and cytokines (Superlymph) one suppository 25 IU at night for 20 days for 1-3 weeks and for 6-8 weeks for 2 months. In group II, antioxidant stimulation of spermatogenesis was prescribed along with suppositories for the prevention of CP for 2 months. The evaluated criteria included sperm analysis, MAR test, oxidative stress in spermatozoa (reactive oxygen species (ROS)) and SDF. The levels of seminal plasma cytokines were also measured before and after treatment in 32 patients using the Bio-Plex Pro panel for the simultaneous determination of 17 human cytokines, the Human Cytokine 17-plex Assay. Statistica-10 software was used for statistical analysis (p<0.05). RESULTS: Of 135 eligible patients, results were collected from 125 men (mean age 31.7 +/- 13.4 years). In group I, there was a more pronounced increase in motility by 42.3%, a decrease in the MAR-test level by 64.7%, oxidative stress in spermatozoa by 56.1%, and SDF by 25.6%, compared to group II (30.4 %, 10.5%, 45.7%, 21.9%), respectively. All these changes were significant with the exception of a decrease in the level of SDF. In group I, there was a predominant increase in the activity of anti-inflammatory cytokines (IL-4, 10, 13), a decrease in the level of pro-inflammatory cytokines ((IL-2, 12). In group II, there was a significant decrease in both pro-inflammatory (IL-2, 6, 8), and anti-inflammatory cytokines (IL-4). The remaining changes were insignificant. Among mild side effects, there were a change in the color of the sclera in 4 (3.2%), anal pain in 3 (2.4%), a decrease in libido in 2 (1.6%) patients. No differences between groups in the frequency of side effects were recorded (p>0.05). CONCLUSION: Antioxidant stimulation of spermatogenesis in infertile men and CP is an effective and safe. The addition of a complex of natural antimicrobial peptides and cytokines (Superlymph) leads to a more profound increase in sperm motility, a decrease in the MAR-test, oxidative stress in sperm cells, which potentiates the effects of therapy. The use of Superlymph is accompanied by a more pronounced positive effect on pathospermia, an increase in anti-inflammatory and a decrease in pro-inflammatory cytokines. In the contrary, in control group, where patients received antioxidant stimulation of spermatogenesis, only a decrease in the level of main cytokines was observed. The effect of a complex of natural antimicrobial peptides and cytokines (Superlymph) on the level of SDF, as well as the relationship with fertility and childbirth rates, requires further study.
ABSTRACT
Novel coronavirus infection 2019 (COVID-19), which is caused by SARS-CoV-2 (severe acute respiratory syndrome related coronavirus-2), leads to a growing concern for public healthcare worldwide. Question about whether SARS-CoV-2 is able to penetrate into testicular tissue and/or seminal fluid remains unanswered. Fertility specialists also encounter many issues regarding prevention and treatment of infertility in patients with a history of COVID-19. There is an increasing number of publications which demonstrate anti-inflammatory, antiviral and antioxidant properties of so-called adaptogenic plants. This was the reason to analyze published articles on the effects of antioxidants and adaptogens on reproductive function in males with a history of COVID-19. © 2021 ABC-press Publishing House. All right reserved.
ABSTRACT
It has been found that men are infected with the coronavirus 1.5 times more often than women, but at the same time 95% of them have mild infection. There are questions that require a scientific explanation: why are men infected more often and more susceptible than women, does the virus cross the blood-testicular barrier, can it be found in the seminal fluid, does SARS-CoV-2 have an effect on the production of androgens, is the testicle affected and what are the consequences of this damage, what is the direct effect of a virus and virus-associated problems (such as social problems, isolation, quarantine, psychological problems, sedentary lifestyle, etc.) primarily on sexual function, sexual behaviour and reproduction in general? The review article examines the SARS-CoV-2 pandemic-associated situation in 2020 and its effect on the men’s health. The article provides data on epidemiology, aspects of pathogenesis, features of new coronavirus infection in men. The authors announced the international reproduction associations (ASRM, ESHRE, RAHR) recommendations for the implementation of assisted reproductive technology (ART) programs in the era of the pandemic. Different points of view on the effect of testosterone on the disease incidence in men are presented. The importance of sperm oxidative stress and antioxidant therapy for male infertility has been shown. The tasks of an international project for the study of SARS-CoV-2 coronavirus infection and its consequences on men’s health are outlined. An invitation to collaboration with domestic and foreign specialists in the field of urology and andrology under the aegis of the National Medical Research Center of Obstetrics, Gynecology and Perinatology named after Academician V.I. Kulakov of the Ministry of Health of the Russian Federation has been published. © 2020, Remedium Group Ltd. All rights reserved.