Male Fertility · Male Factor Treatment
Abstract
Introduction
Currently, infertility is a main concern, and it is estimated that 15% of couples are considered infertile. Conventional therapies such as vitamins, antioxidants and supplements have been used widely, but they may not be sufficiently effective. This study evaluated the effect of laser acupuncture on semen parameters in infertile patients with oligospermia.
Methods
This study is a clinical trial with a double-blind control group. 35 patients in the intervention group underwent laser acupuncture twice a week for consecutive 5-weeks. In the control group, sham laser acupuncture was performed. The two groups were compared in terms of semen parameters including semen volume, sperm concentration, sperm motility and sperm morphology as the primary outcome. The secondary outcome was a successful pregnancy rate. After data collection, statistical analysis was performed with SPSS version 20.
Results
The mean age of all patients was 27.46±2.88 years; in the intervention group, their age was 27.82±2.6 years, and in the control group, it was 27.11±2.96 years, and there was no significant difference (P=0.396). During the study, 4 patients (5.4%) reported adverse effects; three patients in the control group complained of mild weakness and itching, and one patient in the intervention group reported dizziness. The volume of semen and sperm morphology did not differ significantly in both control and intervention groups (P ˃ 0.05), while sperm motility and sperm concentration had a significant difference (P=0.0001).
Conclusion
Laser acupuncture as a non-invasive procedure is effective in improving sperm mobility and concentration in infertile patients with oligospermia. Due to the surface contact of the laser probe with the skin and the lack of need to insert needles in the skin, laser acupuncture is more convenient and better tolerated by patients.
Topics
By this author
Emerging Therapies · Light Therapy
Therapeutic Effects of Low-Level Laser on Male Infertility: A Systematic Review
Eghbaldoost A et al., 2023 · Journal of lasers in medical sciences
The objective of this study was to assess the effectiveness and safety of photobiomodulation (PBM) in the treatment of male infertility. We searched Google Scholar, PubMed, and the reference sections of relevant papers published from January 1, 2000 to September 23, 2022. We retrieved all publications related to the impact of PBM on male infertility. After reviewing the titles, abstracts, and full texts, we included fifteen papers in the research. The studies involved 477 semen samples (in vitro studies) and 70 male participants (randomized clinical trials). All 14 in vitro studies that evaluated effectiveness reported that PBM was successful in increasing the proportion of progressive sperms in semen samples. Various methods were used to evaluate the safety. One study with a sample size of 58 concluded that PBM was not a safe treatment, whereas the other ten studies confirmed its safety. Only one clinical trial evaluated the effect of laser acupuncture on male infertility and found improvements in sperm progressive motility without any serious adverse effects. All 15 studies evaluating effectiveness reported that the low-level laser was effective for increasing the proportion of progressive sperm in semen samples and that it was safe to use. However, due to the heterogeneity of population characteristics, source characteristics, duration of exposure, sample size, and instruments for measuring safety and efficacy, we cannot conclude that the positive results obtained from the reviewed studies are solely attributable to the low-level laser on the sperm samples.
Male Factor Causes · Lifestyle and Environment
Relationship of omega-3 and omega-6 fatty acids with semen characteristics, and anti-oxidant status of seminal plasma: a comparison between fertile and infertile men
Safarinejad MR et al., 2010 · Clinical nutrition (Edinburgh, Scotland)
Fatty acid (FA) composition of the spermatozoa may be an important determinant of fertility. The aim was to evaluate polyunsaturated fatty acid (PUFA) composition of the blood plasma and spermatozoa in infertile men with idiopathic oligoasthenoteratozoospermia (OAT). Eighty-two infertile men with idiopathic OAT and seventy-eight fertile men defined according to semen concentration and proven fertility were enrolled in the study. The semen parameters were assessed according to World Health Organization criteria; three omega-3 fatty acids--alpha-linolenic acid (ALA), eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), and two omega-6 fatty acids--linoleic acid (LA) and arachidonic acid (AA) concentrations were measured in blood plasma and spermatozoa; and the seminal plasma enzymatic antioxidant levels of catalase, and superoxide dismutase (SOD) were also assessed. Proven fertile men had higher blood and spermatozoa levels of omega-3 FAs compared with the infertile patients. The ratio of serum omega-6/omega-3 fatty acids was significantly higher in infertile (14.8+/-4.3) patients compared to fertile controls (6.3+/-2.2) (P=0.001). Additionally, levels of AA were higher and the omega-3 index (EPA+DHA) was lower in infertile subjects than in fertile controls (all P values<0.05). Infertile men had higher mean AA:DHA ratio and AA:EPA (6.4+/-2.9 and 12.0+/-4.9, respectively) than fertile men (3.3+/-1.8 and 6.7+/-2.6, respectively) (both P=0.001). A strong negative correlation was found between the AA:DHA and AA:EPA ratios and total sperm count (r=-0.62, P=0.001 and r=-0.64, P=0.001, respectively), sperm motility (r=-0.63, P=0.001 and r=-0.61, P=0.001, respectively), and sperm morphology (r=-0.61, P=0.001, and r=-0.59, P=0.002, respectively). Infertile men had lower concentrations of omega-3 FAs in spermatozoa than fertile men. These results suggest that research should be performed to assess the potential benefits of omega-3 FA supplementation as a therapeutic approach in infertile men with idiopathic OAT.
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Male Factor Treatment · Medical Management
Treatment of male idiopathic infertility with recombinant human follicle-stimulating hormone: a prospective, controlled, randomized clinical study
Foresta C et al., 2005 · Fertility and sterility
To evaluate the effects of treatment with FSH on seminal parameters and spontaneous pregnancy in male infertility. Prospective, controlled, randomized clinical study. Infertility center at a university hospital. PATIENT(S): One hundred twelve men affected by idiopathic oligozoospermia. INTERVENTION(S): Patients were randomized into two groups: 62 subjects were treated with 100 IU of recombinant human FSH on alternate days for 3 months, and 50 patients did not receive any treatment. Semen analysis was performed in all subjects at the end of this period of treatment and after the following 3 months. Subjects who had not reached spontaneous pregnancy underwent assisted reproductive techniques. MAIN OUTCOME MEASURE(S): Seminal parameters, testicular cytologic analysis, FSH, LH, T, and inhibin B concentrations. RESULT(S): The treatment group considered as a whole did not show modifications in sperm parameters. However, a subgroup of these (30, 48.4%) had a significant increase of sperm count (responder group). In the period including 3 months after the withdrawal of FSH therapy, we observed a significantly higher spontaneous pregnancy rate in the responder group (5 of 30 [16.7%]) with respect to nonresponder and nontreated groups (1 of 32 [3.1%] and 2 of 50 [4.0%], respectively). Furthermore, the improvement of seminal parameters in the responder group allowed these patients to undergo less frequent IVF-ET/intracytoplasmic sperm injection. CONCLUSION(S): Results from this controlled, randomized clinical trial show that FSH therapy does not improve sperm concentration or pregnancy rate when infertile male patients are chosen solely by the clinical criteria of idiopathic oligospermia and normal FSH concentration. Subgroup analysis, however, does indicate that patients without maturation arrest in addition to the clinical scenario do benefit from medical therapy.
Male Factor Treatment · Medical Management
Photobiomodulation with 810 nm Wavelengths Improves Human Sperms' Motility and Viability In Vitro
Safian F et al., 2020 · Photobiomodulation, photomedicine, and laser surgery
Enhanced sperm motility is necessary for the successful journey of sperm inside the female genital tract, successful fertilization, and the increased chance of pregnancy. We investigated the impact of red and near-infrared (NIR) ranges of photobiomodulation (PBM) alone and together on fresh human sperm to validate an optimized PBM protocol that would maximize sperm motility and viability in vitro. We randomly divided 30 normal human semen samples into 3 different PBM protocols (red, NIR, and red+NIR lasers). Each sample was divided into four subparts, one control group sample and three experimental group samples. Each experimental group received one of the PBM protocols (red, NIR, or red+NIR). Each protocol was adjusted to three energy densities (0.6, 1.2, and 2.4 J/cm2). After exposure to the selected protocol, we determined the percentage of either viable or progressive sperm motility (PSM) and measured the DNA Fragmentation Index (DFI). The NIR and red+NIR lasers at 2.4 J/cm2 energy density significantly increased PSM after 60 min compared with the control groups [least significant difference (LSD) test, p = 0.023 and p = 0.04, respectively]. Samples treated with the red laser at 0.6 J/cm2 had significantly decreased viability compared with the control group (LSD test, p = 0.003). Samples treated with the red+NIR lasers had significantly decreased viability at 0.6 J/cm2 (p = 0.003), 1.2 J/cm2 (p = 0.001), and 2.4 J/cm2 (p = 0.04) energy densities when compared with the control groups. The NIR laser resulted in no significant difference in sperm viability between the control and experimental groups. At 120 min after exposure, treatment with the red+NIR and red lasers at 2.4 J/cm2 density significantly increased DFI compared to the control groups (LSD test, p = 0.000, p = 0.007). In this study, sperm motility, viability, and DFI data confirmed the superiority of the NIR laser at 0.6 J/cm2 energy density compared with the red and red+NIR PBM protocols.
Male Factor Treatment · Medical Management
The effects of low-level laser light exposure on sperm motion characteristics and DNA damage
Firestone RS et al., 2012 · Journal of andrology
The objective of this study was to determine the effects of low-level laser light exposure on the motility of spermatozoa and on DNA damage. Thirty-three semen samples were collected for routine analysis and were classified as normospermic, oligospermic, or asthenospermic. After routine semen analysis was performed, residual semen was divided into treated and control aliquots. Treated samples were exposed to a 30-second infrared laser pulse of 50 mW/cm(2) at 905 nm, a wavelength thought to increase light-sensitive cytochrome c oxidase in the mitochondrial electron transport chain. Samples were then incubated at 37°C, and aliquots were analyzed at 30 minutes and 2 hours using computerassisted semen analysis. After incubation, 250 μL of each sample was frozen at 280°C until DNA fragmentation analysis by flow cytometry. A significant increase in motility, most prominent in oligospermic and asthenospermic samples (85% increase), was observed 30 minutes after the treatment (P < .0001). No significant increase in DNA damage compared with control samples was observed. Significant changes in sperm motion kinetics were observed. Low-level laser light exposure appears to have a positive short-term effect on the motility of treated spermatozoa and did not cause any increase in DNA damage measured at 2 hours. We conclude that some cases of asthenospermia may be related to mitochondrial dysfunction. The implications of this study in terms of future clinical applications needs further investigation.
Male Factor Treatment · Medical Management
The power of 810 nm near-infrared photobiomodulation therapy for human asthenozoospermia
Stigliani S et al., 2024 · Scientific reports
Sperm motility is a crucial factor in male fertility. Photobiomodulation (PBM) has been reported to increase sperm motility, but a consistent approach suitable for identifying standardizable protocols is lacking. We collected asthenozoospermic (n = 70) and normozoospermic (n = 20) semen. The asthenozoospermic samples were irradiated with an 810 nm diode laser, in continuous wave mode, at 0.25 W, 0.5 W, 1 W and 2 W for 60 s on a circular area of 1 cm2 through a novel handpiece with an innovative flat-top profile. Sperm motility was assessed immediately, after 30 and 60 min. A sample size calculator, unpaired t-test and one-way ANOVA with post-hoc Tukey HSD tests were used for statistics. One and 2 W were the most effective outputs in increasing progressive motility compared to control (p < 0.001). The maximum effect was immediately after 1 W-PBM (p < 0.001) and decreased after 60 min (p < 0.001). Time physiologically decreased vitality (p < 0.001), but less in the 1 W-PBM samples (p < 0.05). 1 W-PBM did not affect chromatin condensation. Asthenozoospermic samples displayed an impairment of 80% in oxygen consumption and ATP production and a slight inefficiency of oxidative phosphorylation compared to normozoospermic samples (p < 0.001). 1 W-PBM partially restored the functionality of aerobic metabolism (p < 0.001) by recovery of oxidative phosphorylation efficiency. PBM did not affect lactate dehydrogenase (glycolysis pathway). No irradiated samples increased accumulated malondialdehyde, a marker of lipidic peroxidation. In conclusion, PBM improves progressive motility in asthenozoospermia through increased mitochondrial energetic metabolism without harmful oxidative stress.
Male Fertility › Male Factor Treatment › Medical Management · Therapeutics › Emerging Therapies › Light Therapy
Farzad Allameh, Mohammadreza Razzaghi, Maryam Barati, Zahra Razzaghi, Safa Salehi, Seyed Mohammad Ghahestani, Vahid Shahabi
F Allameh, M Razzaghi, M Barati, Z Razzaghi, S Salehi, S Ghahestani, V Shahabi
PMID 35155169 35155169 DOI 10.34172/jlms.2021.84 10.34172/jlms.2021.84 Allameh et al. 2021, Allameh 2021