title: Effect of pentoxifylline on semen parameters, reproductive hormones, and seminal plasma antioxidant capacity in men with idiopathic infertility: a randomized double-blind placebo-controlled study.
abstract: OBJECTIVE
  To determine the safety and efficacy of oral pentoxifylline (PTX) administration in improving semen parameters in infertile men with idiopathic OAT.
  
  
  METHODS
  The study included 254 infertile men who underwent double-blind therapy with 400 mg PTX (Apotex Inc., Toronto, Canada) twice daily (group 1, n = 127), or similar regimen of placebo (group 2, n = 127). The study consisted of a 4-week screening phase, a 24-week treatment phase, and a 12-week treatment-free period. The effects of treatment on semen parameters, serum hormones including testosterone, luteinizing hormone (LH), follicle-stimulating hormone (FSH) and inhibin B, seminal plasma catalase-like and superoxide dismutase (SOD)-like activity, and acrosome reaction test were evaluated.
  
  
  RESULTS
  A significant increase in sperm concentration (mean value, 26.4 ± 4.6 × 10(6)/ml vs. 16.2 ± 3.4 × 10(6)/ml), sperm motility (mean value, 35.8 ± 4.2% vs. 26.4 ± 2.4%), and sperm with normal morphology (mean value, 25.4 ± 4.3% vs. 17.4 ± 4.2%) was observed after PTX administration when compared with baseline (all P = 0.001); in contrast, a subtle decreased values were observed after placebo (median values, 16.4 ± 4.1 × 10(6)/ml vs. 16.7 ± 3.6 × 10(6)/ml, P = 0.1; 25.7 ± 3.6% vs. 26.8 ± 2.5%, P = 0.08; and 16.9 ± 4.1% vs. 17.6 ± 4.4%, P = 0.08, respectively). Mean SOD-like and catalase-like activity in the semen of PTX group was significantly greater than in the semen of placebo group (46.4 ± 2.4 vs. 36.3 ± 1.3 U/ml and 371 ± 44 vs. 301 ± 14 U/ml, respectively, both P = 0.003). The acrosome reaction was observed to be increased in PTX group (P = 0.01). Levels of reproductive hormones were also affected.
  
  
  CONCLUSIONS
  PTX administration significantly improves semen parameters in infertile men with idiopathic OAT.
authors.affiliation: Private Practice of Urology and Andrology, P.O. Box 19395-1849, Tehran, Iran. safarinejad@urologist.md
authors.forename: Mohammad Reza
authors.initials: MR
authors.lastname: Safarinejad
mesh_terms: D000328:Adult; D004311:Double-Blind Method; D006728:Hormones / Q000097:blood; D006801:Humans; D007248:Infertility, Male / Q000097:blood / Q000188:drug therapy* / Q000378:metabolism*; D008297:Male; D010431:Pentoxifylline / Q000494:pharmacology* / Q000627:therapeutic use*; D010726:Phosphodiesterase Inhibitors / Q000494:pharmacology* / Q000627:therapeutic use*; D011446:Prospective Studies; D012661:Semen / Q000187:drug effects* / Q000201:enzymology*; D013094:Spermatozoa / Q000187:drug effects*; D013482:Superoxide Dismutase / Q000378:metabolism
chemical_list: D006728:Hormones; D010726:Phosphodiesterase Inhibitors; D013482:Superoxide Dismutase; D010431:Pentoxifylline
references.citation: Lancet. 1997 Mar 15;349(9054):787-90
references.pmid: 9074589
references.citation: J Assist Reprod Genet. 2002 Jun;19(6):279-83
references.pmid: 12166633
references.citation: Prostaglandins Leukot Med. 1982 Jan;8(1):55-62
references.pmid: 6281809
references.citation: N Engl J Med. 2002 Mar 7;346(10):725-30
references.pmid: 11882727
references.citation: Arch Androl. 1997 Jul-Aug;39(1):65-9
references.pmid: 9202835
references.citation: Int J Immunopharmacol. 1996 Dec;18(12):739-48
references.pmid: 9172017
references.citation: J Med Assoc Thai. 2007 Feb;90(2):211-5
references.pmid: 17375622
references.citation: Mol Hum Reprod. 1999 Nov;5(11):1017-26
references.pmid: 10541563
references.citation: J Androl. 2006 Jan-Feb;27(1):45-52
references.pmid: 16400077
references.citation: Fertil Steril. 1950 Sep;1(5):415-22
references.pmid: 14778405
references.citation: Immunology. 1993 Sep;80(1):151-6
references.pmid: 8244458
references.citation: Biochim Biophys Acta. 1991 May 6;1057(3):281-98
references.pmid: 1851438
references.citation: J Androl. 2002 Nov-Dec;23(6):737-52
references.pmid: 12399514
references.citation: Hum Reprod Update. 2002 May-Jun;8(3):265-77
references.pmid: 12078837
references.citation: Fertil Steril. 1999 May;71(5):919-23
references.pmid: 10231057
references.citation: J Assist Reprod Genet. 2000 Apr;17(4):194-9
references.pmid: 10955242
references.citation: Mol Aspects Med. 2002 Feb-Jun;23(1-3):209-85
references.pmid: 12079772
references.citation: Med Clin North Am. 2004 Mar;88(2):367-85
references.pmid: 15049583
references.citation: Clin Sci (Lond). 2002 Aug;103(2):163-9
references.pmid: 12149108
references.citation: Andrologia. 1985 Nov-Dec;17(6):612-6
references.pmid: 4083550
references.citation: Fertil Steril. 1986 Mar;45(3):392-6
references.pmid: 3081382
references.citation: Cochrane Database Syst Rev. 2000;(2):CD000151
references.pmid: 10796497
references.citation: Hum Reprod. 1993 Oct;8(10):1657-62
references.pmid: 8300824
references.citation: J Androl. 1994 Jul-Aug;15(4):343-52
references.pmid: 7982803
references.citation: Urol Res. 2002 Oct;30(5):321-3
references.pmid: 12389121
references.citation: Andrologia. 2011 Feb;43(1):38-47
references.pmid: 21219381
references.citation: Arch Androl. 1996 Mar-Apr;36(2):139-43
references.pmid: 8907675
references.citation: J Urol. 2006 Oct;176(4 Pt 1):1307-12
references.pmid: 16952617
references.citation: Acta Eur Fertil. 1994 Nov-Dec;25(6):351-3
references.pmid: 8838877
references.citation: Int J Androl. 2008 Jun;31(3):303-14
references.pmid: 17488339
references.citation: Infect Immun. 1992 Nov;60(11):4504-9
references.pmid: 1356929
references.citation: Fertil Steril. 2003 Feb;79(2):292-300
references.pmid: 12568837
references.citation: Soc Sci Med. 1999 Mar;48(5):575-89
references.pmid: 10080360
references.citation: Arch Androl. 1997 Jul-Aug;39(1):1-9
references.pmid: 9202827
references.citation: Arch Androl. 2003 Mar-Apr;49(2):83-94
references.pmid: 12623744
references.citation: Andrologia. 1994 May-Jun;26(3):155-9
references.pmid: 8085668
references.citation: J Assist Reprod Genet. 1996 Jul;13(6):495-500
references.pmid: 8835679
references.citation: J Androl. 1989 May-Jun;10(3):240-7
references.pmid: 2663800
references.citation: Infect Immun. 1988 Jul;56(7):1722-9
references.pmid: 2838424
references.citation: J Pediatr Gastroenterol Nutr. 1999 Jul;29(1):69-74
references.pmid: 10400107
references.citation: J Urol. 2009 Jul;182(1):237-48
references.pmid: 19447425
references.citation: Fertil Steril. 2008 Sep;90(3):627-35
references.pmid: 18001713
references.citation: J Reprod Fertil. 1987 Nov;81(2):459-69
references.pmid: 2828610
references.citation: J Urol. 2009 Feb;181(2):741-51
references.pmid: 19091331
references.citation: Hum Reprod. 2002 Nov;17(11):2813-24
references.pmid: 12407032
references.citation: Lancet. 1989 Dec 23-30;2(8678-8679):1474-7
references.pmid: 2574766
references.citation: Fertil Steril. 2009 Apr;91(4 Suppl):1536-9
references.pmid: 18990381
references.citation: Hum Reprod Update. 1999 Sep-Oct;5(5):393-8
references.pmid: 10582779
references.citation: Fertil Steril. 1992 Dec;58(6):1185-90
references.pmid: 1333994
references.citation: J Androl. 2002 Sep-Oct;23(5):709-16
references.pmid: 12185106