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Effect Of Medications On Semen Analysis And Sperm Chromatin Structure Assay (SCSA) Parameters

This research presented at the American Association of Bioanalysts (AAB), Los Vegas, 2004.

CA Adams, LS Anderson, J.C. Juanengo and SH Wood. Reproductive Sciences Center, La Jolla, CA, USA.

Objective: To evaluate several classes of commonly prescribed medications for their possible effects on the DNA Fragmentation Index (DFI) and High DNA Stainability (HDS) tests, as well as traditional semen parameters.

Design: A retrospective study of 146 males undergoing pre-IVF semen analysis and SCSA testing (DFI and HDS).

Materials and Methods: Standard semen parameters (count, motility and morphology) and SCSA scores were compared in 100 males taking no medications and 46 males taking various medications at the time of testing. Patients were grouped according to the class of medication (cholesterol lowering agents, 5α-reductase inhibitors, antihypertensives, psychoactive agents, antiulcer agents and antihistamines) they were taking. Men with a history of reproductive tract abnormalities (including varicocele), a reproductive surgical history, tobacco use, excessive alcohol or caffeine use, or exposure to environmental toxins or heat were excluded. Statistical analysis was done using the Student’s t-Test or ANOVA (with post-hoc analysis) as appropriate..

Results: The mean age of men taking a medication (43.7±7) was not significantly higher than those not taking any medication (40.3±6 y). There was, however, a significant decrease in percent motile sperm in men taking anti-ulcer (38.7%, p< 0.05) or cholesterol lowering agents (39.1%, p< 0.05) as compared with those on no medications (61%). The DFI in men ingesting anti-ulcer (38%, p <0.0001) or cholesterol lowering agents (39%, p<0.05) was significantly higher than those not taking any medications. Males taking 5α-reductase inhibitors had significantly higher HDS scores (17%, p<0.005) than those on no medications (9%). No effect of any class of medication was seen on sperm count or morphology.

Conclusions: This preliminary data indicates that anti-ulcer agents and cholesterol lowering agents are associated with decreased sperm motility and an increase in SCSA-defined DNA fragmentation. The increase in sperm DNA stainability seen in the men taking 5α-reductase inhibitors suggests a possible effect of these agents on sperm chromatin condensation. Given the large number of men prescribed these medications, their ingestion may play an important role in elucidating male infertility currently classified as idiopathic. Because the sample groups are small, further studies are needed to confirm these data. However, pending such studies, consideration may be given to advising men with abnormal semen parameters to discontinue these medications, if medically possible, at least 3 months prior to treatment.