Zaditen (Ketotifen), as mast cell blocker, improves sperm quality, chromatin integrity and pregnancy rate after varicocelectomy

Abstract

Surgery is considered the most common choice for the treatment of male infertility with clinical varicocele. Increased numbers of mast cells (MCs) have been associated with different types of infertility, including varicocele. Despite there being different reports on improved fertility following administration of MC blockers, there is no report on the effect of a MC blocker on varicocele or after varicocelectomy. Therefore, the aim of this study was to evaluate the effect of Zaditen on semen quality, protamine content, DNA damage and fertility post-surgery. The study included 103 infertile men who were referred to Isfahan Fertility and Infertility Center for varicocelectomy. Varicocele individuals were randomly divided into control (52) and treatment groups (51). Semen parameters, WBC/mL, protamine content (chromomycin A3 staining) and DNA integrity (sperm chromatin dispersion test) were assessed before and 3 months after surgery. Comparison of the aforesaid parameters between the two groups revealed significant improvement in the treatment group compared with the control group, with the exception of DNA integrity. In addition, the cumulative pregnancy significantly improved by 9 months post-surgery in the treatment group (41.17%) compared with the control group (21.15%). The results of this study, for the first time, reveal that MC blockers such as Zaditen improve semen parameters, chromatin integrity and pregnancy rates when administered as adjunct therapy post-varicocelectomy.

Are varicoceles associated with increased deoxyribonucleic acid fragmentation?

“…To validate the observed association between varicocele and sperm DNA fragmentation, several investigators have examined the effect of varicocelectomy on sperm DNA damage. There are now three retrospective and nine prospective studies on the effect of varicocelectomy on sperm DNA damage, and these studies have all shown that varicocele repair is associated with reduced sperm DNA damage (8,33,36,(71)(72)(73)(74)(75)(76)(77)(78)(79) (Table 2). Although there are no randomized controlled trials on the role of varicocelectomy on sperm DNA integrity, the published varicocelectomy studies provide indirect evidence in support of the adverse effect of varicocele on sperm DNA integrity.…”

Human testicular peritubular cells: more than meets the eye

“…One approach, the pharmacological inhibition of testicular mast cells, was indeed explored in the past in a limited number of subfertility patients. The reported results were, in general, promising and describe amelioration of subfertility (Matsuki et al 2000, Azadi et al 2011, Haidl et al 2011. Large, controlled, and randomized studies are, however, urgently required in the future to better address this point and to extend it beyond mast cells.…”

The role of varicocele treatment in the management of non-obstructive azoospermia

“…Additionally, after varicocele repair, an increase in the semen antioxidant capacity is observed (42). Several prospective and retrospective studies on the effect of varicocelectomy on sperm DNA damage have demonstrated that varicocele repair is associated with reduced sperm DNA damage (43-46). However, no randomized controlled trial has been conducted regarding the role of varicocelectomy in sperm DNA integrity.…”