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.
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.
Safarinejad
Mohammad Reza
MR
Private Practice of Urology and Andrology, P.O. Box 19395-1849, Tehran, Iran. safarinejad@urologist.md
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
D006728:Hormones; D010726:Phosphodiesterase Inhibitors; D013482:Superoxide Dismutase; D010431:Pentoxifylline
Lancet. 1997 Mar 15;349(9054):787-90
9074589
J Assist Reprod Genet. 2002 Jun;19(6):279-83
12166633
Prostaglandins Leukot Med. 1982 Jan;8(1):55-62
6281809
N Engl J Med. 2002 Mar 7;346(10):725-30
11882727
Arch Androl. 1997 Jul-Aug;39(1):65-9
9202835
Int J Immunopharmacol. 1996 Dec;18(12):739-48
9172017
J Med Assoc Thai. 2007 Feb;90(2):211-5
17375622
Mol Hum Reprod. 1999 Nov;5(11):1017-26
10541563
J Androl. 2006 Jan-Feb;27(1):45-52
16400077
Fertil Steril. 1950 Sep;1(5):415-22
14778405
Immunology. 1993 Sep;80(1):151-6
8244458
Biochim Biophys Acta. 1991 May 6;1057(3):281-98
1851438
J Androl. 2002 Nov-Dec;23(6):737-52
12399514
Hum Reprod Update. 2002 May-Jun;8(3):265-77
12078837
Fertil Steril. 1999 May;71(5):919-23
10231057
J Assist Reprod Genet. 2000 Apr;17(4):194-9
10955242
Mol Aspects Med. 2002 Feb-Jun;23(1-3):209-85
12079772
Med Clin North Am. 2004 Mar;88(2):367-85
15049583
Clin Sci (Lond). 2002 Aug;103(2):163-9
12149108
Andrologia. 1985 Nov-Dec;17(6):612-6
4083550
Fertil Steril. 1986 Mar;45(3):392-6
3081382
Cochrane Database Syst Rev. 2000;(2):CD000151
10796497
Hum Reprod. 1993 Oct;8(10):1657-62
8300824
J Androl. 1994 Jul-Aug;15(4):343-52
7982803
Urol Res. 2002 Oct;30(5):321-3
12389121
Andrologia. 2011 Feb;43(1):38-47
21219381
Arch Androl. 1996 Mar-Apr;36(2):139-43
8907675
J Urol. 2006 Oct;176(4 Pt 1):1307-12
16952617
Acta Eur Fertil. 1994 Nov-Dec;25(6):351-3
8838877
Int J Androl. 2008 Jun;31(3):303-14
17488339
Infect Immun. 1992 Nov;60(11):4504-9
1356929
Fertil Steril. 2003 Feb;79(2):292-300
12568837
Soc Sci Med. 1999 Mar;48(5):575-89
10080360
Arch Androl. 1997 Jul-Aug;39(1):1-9
9202827
Arch Androl. 2003 Mar-Apr;49(2):83-94
12623744
Andrologia. 1994 May-Jun;26(3):155-9
8085668
J Assist Reprod Genet. 1996 Jul;13(6):495-500
8835679
J Androl. 1989 May-Jun;10(3):240-7
2663800
Infect Immun. 1988 Jul;56(7):1722-9
2838424
J Pediatr Gastroenterol Nutr. 1999 Jul;29(1):69-74
10400107
J Urol. 2009 Jul;182(1):237-48
19447425
Fertil Steril. 2008 Sep;90(3):627-35
18001713
J Reprod Fertil. 1987 Nov;81(2):459-69
2828610
J Urol. 2009 Feb;181(2):741-51
19091331
Hum Reprod. 2002 Nov;17(11):2813-24
12407032
Lancet. 1989 Dec 23-30;2(8678-8679):1474-7
2574766
Fertil Steril. 2009 Apr;91(4 Suppl):1536-9
18990381
Hum Reprod Update. 1999 Sep-Oct;5(5):393-8
10582779
Fertil Steril. 1992 Dec;58(6):1185-90
1333994
J Androl. 2002 Sep-Oct;23(5):709-16
12185106