- Sara Soleimani Asl
- - Anatomy Department, Faculty of Medicine, Isfahan Medical Sciences University, Isfahan, Iran
- Homayoun Abbasi
- - Department of Urology, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
- Mohammad Hossein Nasr-Esfahani
 - - Embryology Department, Royan Institute, Iranian Academic Center for Education, Culture & Research (ACECR), Tehran, Iran
- Shahnaz Razavi
- - Anatomy Department, Faculty of Medicine, Isfahan Medical Sciences University, Isfahan, Iran
- Mohammad Mardani
- - Anatomy Department, Faculty of Medicine, Isfahan Medical Sciences University, Isfahan, Iran
Received: 4/1/2004 Accepted: 4/1/2004 - Publisher : Avicenna Research Institute |
|
| Related Articles |
|
| Other Format |
|
|
|
Abstract
Introduction: Mast cells play an important role in inflammation, hypersensitivity and fibrosis. Mast cells are normally present in most of peripheral tissues including testes. Studies of literatures suggest that there is a prominent increase in number of testicular mast cells in testes of infertile patients which might result in peritubular fibrosis and consequently disruption in spermatogenesis. Therefore, it appears that treatment with mast cell blockers prevents mast cell release of vasoactive substances and thereby, reduction in inflammation and fibrosis might improve semen parameters. The aim of this study was to evaluate the effect of ketotifen, as a mast cell blocker, on semen parameters and sperm chromatin quality in infertile males. Materials and Methods: This prospective study was carried out on 10 oligospermic and 14 non-oligospermic infertile males, who referred to Isfahan Fertility and Infertility Center, all of cases had normal gonadotropin and testosterone levels, without female factor defect. The two groups were treated with 1mg ketotifen, twice daily for 3 months. Semen parameters and sperm chromatin (CMA3 and aniline blue staining) were assessed on days 0, 45 and 90 after ketotifen administration. Results were analyzed by SPSS software using paired samples student t-test. Results: In the oligospermic group, only seminal volume increased significantly on day 45 (P=0.005), however on day 90, seminal volume, total sperm density, percentage of normal morphology, normal head morphology and sperms with normal histone were increased significantly (P≤0.05), though sperm motility decreased (P=0.025). Two pregnancies were recorded in this group (20%). In non-oligospermic infertile males, the sperm density decreased significantly on day 45 compared to day 0(P=0.03), however, this value rebounded to pre-treatment value by day 90 (P>0.05). The percentage of sperms with normal morphology, normal head and normal histones increased significantly on day 90 (P≤0.05), whereas, percentage of protamine deficient sperm decreased significantly (P≤0.05). Two pregnancies were recorded in this group (14.3%). The mean values of FSH, LH and testosterone did not change significantly before and after treatment (P>0.05). Conclusion: Considering the improved sperm morphology and sperm chromatin quality, treatment with ketotifen as a mast cell blocker is advised for the treatment of unexplained infertility patients. Meanwhile, since the success rate of Assisted Reproduction Technique (ART) depends on the quality of sperm, pretreatment ketotifen is recommended for patients who undergo ART.
Keywords:
Mast cell, Ketotifen, Sperm chromatin, Sperm Parameters, Oligospermia, Infertility To cite this article:References
- Jaffe S.B., Jewelewicz R. The basic infertility investigation. Fertil Steril.1991;56(4):599-613.
- Maseki Y., Miyake K., Mitsuya H., Kitamura H., Yamada K. Mastocytosis occurring in the test- es from patients with idiopathic male infertility. Fertil Steril.1981;36(6):814-7.
- Meineke V., Frungieri M.B., Jessberger B., Vogt H., Mayerhofer A. Human testicular mast cells contain tryptase: increased mast cell number and altered distribution in the testes of infertile
- Metcalfe D.D., Baram D., Mekori Y.A. Mast cells. Physiol Rev.1997;77(4):1033-79.
- Cairns J.A., Walls A.F. Mast cell tryptase stim-ulates the synthesis of type I collagen in human lung fibroblasts.J Clin Invest.1997;99(6):1313-21.
- Nagai T., Takaba H., Miyake K., Hirabayashi Y., Yamada K. Testicular mast cell heterogeneity in idiopathic male infertility. Fertil Steril.1992;57 (6):1331-6.
- Apa D.D., Cayan S., Polat A., Akbay E. Mast cells and fibrosis on testicular biopsies in male infertility. Arch Androl.2002;48(5):337-44.
- Ruoss S.J., Hartmann T., Caughey G.H. Mast cell tryptase is a mitogen for cultured fibroblasts. J Clin Invest.1991;88(2):493-9.
- Haidl G., Schill W.B. Guidelines for drug treatment of male infertility. Drugs.1991;41(1): 60-8.
- Schill W.B., Schneider J., Ring J. The use of ketotifen, a mast cell blocker, for treatment of oligoasthenozoospermia.Andrologia.1986;18: 570-3.
- Yamamoto M., Hibi H., Miyake K. Appear-ance of spermatozoon after administration of mast cell blocker to a patient with azoospermia. Hinyo- kika Kiyo.1994;40(6):541-3.
- Cayan S., Apa D.D., Akbay E.Effect of fexo-fenadin, a mast cell blocker, in infertile men with significantly increased testicular mast cells. Asia J Androl.2002;4:291-294.
- World health organization(WHO). Laboratory manual for the examination of human sperm and sperm- cervical mucus interaction. 3th Edition New York, Cambridge university press. Cambri-dge.1992.pp:1-15.
- Comhaire F., Vermeulen L. Human semen analysis. Hum Reprod.1995;1(4):343-362.
- Kruger T.F., Acosta A.A., Simmons K.F., Swa-nson R.J., Matta J.F., Oehninger S. Predictive value of abnormal sperm morphology in invitro fertiliza-tion. Fertil Steril.1988;49:112-117.
- Nasr-Esfahani M.H., Razavi S., Mardani M. Relation between different human sperm nuclear maturity tests and In Vitro Fertilization. J Assist Reprod Genet.2001;18(4):219-25.
- Hammadeh M.E., Stieber M., Haidl G., Schm-idt W. Association between sperm cell chromatin condensation, morphology based on strict criteria, and fertilization, cleavage and pregnancy rates in an IVF program. Andrologia. 1998;30(1):29-35.
- Young L.C. The mast cell: origin, morpho- logyand function. Exp Toxico Pathol. 1997;49:409-424.
- Cincik M., Sezen S.C.The mast cells in semen: their effects on sperm motility. Arch And- rol. 2003;49(4):307-11.
- Hashimoto J., Nagai T., Takaba H.,Yamamoto M., Miyake K. Increased mast cells in the limiting membrane of seminiferous tubules in testes of pat-ients with idiopathic infertility. Urol Int.1988;43 (3):129-32.
- Matsuki S., Sasagawa I., Suzuki Y., Yazawa H., Tateno T., Hashimoto T., Nakada T., Saito H., Hiroi M. The use of ebastine, a mast cell blocker, for treatment of oligozoospermia. Arch Androl. 2000;44(2):129-32.
- Hibi H., Kato K., Mitsui K., Taki T., Yamada Y., Honda N., Fukatsu H., Yamamoto M. The treatment with tranilast, a mast cell blocker, for idiopathic oligozoospermia. Arch Androl.2001; 47(2):107-11.
- Hibi H., Kato K., Mitsui K., Taki T., Yamada Y., Honda N., Fukatsu H., Yamamoto M. Treat-ment of oligoasthenozoospermia with tranilast, a mast cell blocker, after long-term administration. Arch Androl.2002;48(6):451-9.
- Akiyama H., Oeda T., Ichikawa T., Ozawa H., Nagai A., Ohmori H. Clinical evalution of Tranil-ast on idiopathic male infertility. Jpn Fertil Steril. 1996;41:54-58.
- Yamamoto M., Hibi H., Miyake K. New treat-ment of idiopathic severe oligozoospermia with mast cell blocker: results of a single-blind study. Fertil Steril.1995;64(6):1221-3.
- Sakkas D., Mariethoz E., St John J.C. Abnor-mal sperm parameters in humans are indicative of an abortive apoptotic mechanism linked to the Fas-mediated pathway. Exp Cell Res.1999;251(2) :350-5.
- Rogers B.J., Bentwood B.J., Van Campen H., Helmbrecht G., Soderdahl D., Hale R.W. Sperm morphology assessment as an indicator of human fertilizing capacity. J Androl.1983;4(2):119-25.
- Lundin K., Soderlund B., Hamberger L. The relationship between sperm morphology and rates of fertilization, pregnancy and spontaneous abor-tion in an in-vitro fertilization/ intracytoplasmic sperm injection programme. Hum Reprod.1997; 12(12):2676-81.
- De Vos A., Van De Velde H., Joris H., Verhe-yen G., Devroey P., Van Steirteghem A. Influence of individual sperm morphology on fertilization, embryo morphology, and pregnancy outcome of intracytoplasmic sperm injection. Fertil Steril.2003; 79(1):42-8.
- Nasr-Esfahani M.H., Razavi S., Mardani M., Tofigh Hesabi S. Effeciency of sil-select and percoll to recover spermatozoa with normal chro-matin and morphology and the effect these param-eters on fertilization, embryo quality and cleavage
- Bartoov B., Berkovitz A., Eltes F., Kogosows- ki A., Menezo Y., Barak Y. Real-time fine morph-ology of motile human sperm cells is associated with IVF-ICSI outcome. J Androl.2002;23(1):1-8.
- Jezek D., Banek L., Hittmair A., Pezerovic-Panijan R., Goluza T., Schulze W. Mast cells in testicular biopsies of infertile men with 'mixed atrophy' of seminiferous tubules. Andrologia.1999 ;31(4):203-10.