Pentoxifylline treatment had no detrimental effect on sperm DNA integrity and clinical characteristics in cases with non-obstructive azoospermia

Abstract

Summary The aim of this study was to assess the consequences of treatment with pentoxifylline (PTX), an inducer of sperm motility, on sperm DNA fragmentation (SDF) and clinical characteristics in non-obstructive azoospermia (NOA) patients. The pilot study included 15 NOA patients. Half of each sperm sample before and after rapid freezing, was treated with PTX (3.6 mM /l, 30 min) as the PTX group and the remaining samples were considered as the control. SDF and sperm motility were assessed in each group. The clinical study comprised 30 fresh testicular sperm extractions (TESE) and 22 post-thawed TESE intracytoplasmic sperm injection cycles. Half of the mature oocytes from each patient were injected with PTX-treated spermatozoa and the remaining oocytes were injected with non-treated spermatozoa. Fertilization was assessed at 16 h post injection. Embryo transfer was carried out on day 2 after fertilization. Chemical pregnancy was assessed 2 weeks after transfer. PTX was found to significantly increase (P < 0.05) sperm motility. There was an insignificant difference in SDF rates between the groups (P > 0.05). In patient ovaries given fresh TESE, there was not any significant difference in clinical characteristics (P > 0.05). In patient ovaries given post-thawed TESE, there was a significant difference in the number of 2PN and in embryo formation (P < 0.05). Differences in the results of chemical pregnancy were insignificant (P > 0.05) between the groups. In addition, there was not any correlation between DNA fragmentation index and sperm motility and laboratory outcomes. Therefore, obtaining viable spermatozoa using PTX was more effective in post-thawed TESE regime patients in terms of 2PN and in embryo formation, deprived of damaging effects on sperm DNA integrity.

Reviving Spermatogenesis: A Case Report on an Approach to Treat Non-obstructive Azoospermia Using Theophylline, Pentoxifylline, and Hyaluronic Acid

“…This supports our study, as TESA showed positive results compared to PESA. Mahaldashtian et al [ 19 ] explained that the acquisition of viable sperm with pentoxifylline was more effective in terms of 2 pronuclear (2PN) and embryo development in patients with the post-thawed testicular sperm extraction (TESE) protocol without negative impacts on the integrity of sperm DNA. Oraibi et al [ 20 ] concluded in their study that theophylline significantly reduced the time required for sperm isolation from fresh testicular samples, improved embryo quality, significantly increased implantation rate in ICSI procedures, and significantly improved biochemical and clinical pregnancy outcomes in ICSI procedures performed on male patients.…”

The effect of pentoxifylline and calcium ionophore treatment on sperm cell biology in oligoasthenoteratozoospermia samples

“…The former study indicated that the use of CI did not alter DNA fragmentation because DNA in sperm cells is mostly protamine bound (Engel et al, 2018) and so packed more tightly than in somatic cells, which could avoid DNA fragmentation (Engel et al, 2018). Some studies using sperm chromatin dispersion (SCD) staining have indicated that PTX has no adverse effect on sperm chromatin/DNA integrity (Nabi et al, 2017;Mahaldashtian et al, 2022).…”