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Abstrakt
Antioxidants Attenuate the Effects of Insulin Dependent Diabetes Mellitus on Sperm Quality
Omu AE, Al-Bader MD, Al-Jassar WF, Al-Azemi MK1, Omu FE, Mathew TC and Anim JT
Introduction: The prevalence of Diabetes Mellitus has been increasing in an epidemic proportion worldwide and it is associated with impairment of sperm quality and cause infertility. The role of antioxidants therapy to improve human sperm quality has not been established.
Objective of study: To investigate the effect of antioxidants therapy on sperm quality in men with insulin dependent diabetes mellitus.
Materials and methods: Forty-five men with insulin dependent diabetes attending the andrology clinic, between January 2008 and December 2012 seen at the Maternity Hospital, Kuwait, form the subjects of this study. Thirty nondiabetic infertile men matched for age and duration of infertility formed the control group. The study protocol included initial pretherapy and post-therapy clinical evaluation of all the patients, semen analysis, hormone profile, glycosylated haemoglobin (HbA1C), Malonedialdehyde (MDA), lipid profile, Acridine orange denaturation of sperm for evaluation of sperm DNA fragmentation index and light and electron microscopy. The patients were administered Zinc, Selenium and vitamins E and C for three months and revaluated.
Results: Diabetes mellitus was associated with significantly impaired sperm motility (asthenozoospermia) compare to control (64% versus 36%) (P<0.05), normal sperm morphology (66% versus 52%) (p<0.05), higher HbA1C (9.6% versus 4.4%, P<0.05) and oxidative stress (MDA) (2.4 versus 1.4 nmol/L, P<0.01) and reduced antioxidant status. Antioxidant therapy significantly decreased glucose level, 18-40% p<0.05; HbA1c 9-29% p<0.05; MDA level 33-41%, P<0.01; and Sperm DNA Fragmentation index, 23-33%, p<0.01) and Increase in BuChE 21-40%, p<0.05 and TAC, 27- 36%, p<0.05.
Conclusion: Diabetes mellitus particularly with poor glycemic control is associated with impaired sperm quality, involving oxidative stress in the pathogenesis. Antioxidant therapy has been shown to significantly improve the sperm quality.