Skip to main content

Nonhormonal Medical Treatment of Male Infertility

  • Living reference work entry
  • First Online:
  • 209 Accesses

Part of the book series: Endocrinology ((ENDOCR))

Abstract

A nonhormonal medical treatment can be used in patients with male infertility. When the cause has not been identified, the treatment is defined empirical and the empirical nonhormonal medical treatment involves the use of anti-inflammatory, fibrinolytic and antioxidant compounds, oligo-elements, and vitamin supplementation. This empirical therapy is prescribed to patients with idiopathic or noncurable oligo-astheno-teratozoospermia and for selected normozoospermic infertile patients. The treatment is defined rational if the pathogenic mechanism can be solved or the cause be ameliorated through the use of specific treatment. This includes antibiotics, anti-inflammatory drugs, and/or antioxidants required for infection, inflammation, and/or increased oxidative stress. Combined therapies can contribute to the improvement of sperm quality.

This is a preview of subscription content, log in via an institution.

References

  • Abd-Allah AR, Aly HA, Moustafa AM, Abdel-Aziz AA, Hamada FM. Adverse testicular effects of some quinolone members in rats. Pharmacol Res. 2000;41(2):211.

    Article  CAS  PubMed  Google Scholar 

  • Abel BJ, Carswell G, Elton R, Hargreave TB, Kyle K, Orr S, Rogers A, Baxby K, Yates A. Randomised trial of clomiphene citrate treatment and vitamin C for male infertility. Br J Urol. 1982;54:780.

    Article  CAS  PubMed  Google Scholar 

  • Agarwal A, Said TM. Carnitines and male infertility. Reprod BioMed Online. 2004;8(4):376.

    Article  CAS  PubMed  Google Scholar 

  • Agarwal A, Nallella KP, Allamaneni SS, Said TM. Role of antioxidants in treatment of male infertility: an overview of the literature. Reprod BioMed Online. 2004;8:616.

    Article  CAS  PubMed  Google Scholar 

  • Agarwal A, Sharma RK, Desai NR, Prabakaran S, Tavares A, Sabanegh E. Role of oxidative stress in pathogenesis of varicocele and infertility. Urology. 2009;73:461.

    Article  PubMed  Google Scholar 

  • Agarwal A, Virk G, Ong C, du Plessis SS. Effect of oxidative stress on male reproduction. World J Mens Health. 2014;32:1.

    Article  PubMed  PubMed Central  Google Scholar 

  • Aitken RJ. The Amoroso Lecture. The human spermatozoon–a cell in crisis? J Reprod Fertil. 1999;115:1.

    Article  CAS  PubMed  Google Scholar 

  • Balercia G, Regoli F, Armeni T, Koverech A, Mantero F, Boscaro M. Placebo-controlled double-blind randomized trial on the use of L-carnitine, L-acetylcarnitine, or combined L-carnitine and L-acetylcarnitine in men with idiopathic asthenozoospermia. Fertil Steril. 2005;84(3):662.

    Article  CAS  PubMed  Google Scholar 

  • Balercia G, Buldreghini E, Vignini A, Tiano L, Paggi F, Amoroso S, Ricciardo-Lamonica G, Boscaro M, Lenzi A, Littarru G. Coenzyme Q10 treatment in infertile men with idiopathic asthenozoospermia: a placebo-controlled, double-blind randomized trial. Fertil Steril. 2009;91(5):1785.

    Article  CAS  PubMed  Google Scholar 

  • Banihani S, Agarwal A, Sharma R, Bayachou M. Cryoprotective effect of l-carnitine on motility, vitality and DNA oxidation of human spermatozoa. Andrologia. 2014;46(6):637.

    Article  CAS  PubMed  Google Scholar 

  • Bornman MS, du Toit D, Otto B, Müller II, Hurter P, du Plessis DJ. Seminal carnitine, epididymal function and spermatozoal motility. S Afr Med J. 1989;75(1):20.

    CAS  PubMed  Google Scholar 

  • Bundrick W, Heron SP, Ray P, et al. Levofloxacin versus ciprofloxacin in the treatment of chronic bacterial prostatitis: a randomized double-blind multicenter study. Urology. 2003;62:537.

    Article  PubMed  Google Scholar 

  • Busetto GM, Koverech A, Messano M, Antonini G, De Berardinis E, Gentile V. Prospective open-label study on the efficacy and tolerability of a combination of nutritional supplements in primary infertile patients with idiopathic astenoteratozoospermia. Arch Ital Urol Androl. 2012;84:137.

    PubMed  Google Scholar 

  • Byun JS, Yoon TK, Rhee HW, Kim JH, Shin JS, Kim HS, Bak CW. Chronic pelvic pain syndrome and semen quality of Korean men in their fourth decade. J Androl. 2012;33(5):876.

    Article  CAS  PubMed  Google Scholar 

  • Calogero AE, Gullo G, La Vignera S, Condorelli RA, Vaiarelli A. Myoinositol improves sperm parameters and serum reproductive hormones in patients with idiopathic infertility: a prospective double-blind randomized placebo-controlled study. Andrology. 2015;3(3):491.

    Article  CAS  PubMed  Google Scholar 

  • Canale D, Scaricabarozzi I, Giorgi P, Turchi P, Ducci M, Menchini-Fabris GF. Use of a novel non-steroidal anti-inflammatory drug, nimesulide, in the treatment of abacterial prostatovesiculitis. Andrologia. 1993;25(3):163.

    Article  CAS  PubMed  Google Scholar 

  • Castellini C, Lattaioli P, Bernardini M, Dal Bosco A. Effect of dietary alpha-tocopheryl acetate and ascorbic acid on rabbit semen stored at 5 degrees C. Theriogenology. 2000;54(4):523.

    Article  CAS  PubMed  Google Scholar 

  • Cheraghi E, Mehranjani MS, Shariatzadeh MA, Esfahani MH, Ebrahimi Z. N-Acetylcysteine improves oocyte and embryo quality in polycystic ovary syndrome patients undergoing intracytoplasmic sperm injection: an alternative to metformin. Reprod Fertil Dev. 2016;28(6):723.

    Article  CAS  PubMed  Google Scholar 

  • Ciftci H, Verit A, Savas M, Yeni E, Erel O. Effects of N-acetylcysteine on semen parameters and oxidative/antioxidant status. Urology. 2009;74(1):73.

    Article  PubMed  Google Scholar 

  • Comhaire FH, Christophe AB, Zalata AA, Dhooge WS, Mahmoud AM, Depuydt CE. The effects of combined conventional treatment, oral antioxidants and essential fatty acids on sperm biology in subfertile men. Prostaglandins Leukot Essent Fat Acids. 2000;63(3):159.

    Article  CAS  Google Scholar 

  • Comhaire FH, El Garem Y, Mahmoud A, Eertmans F, Schoonjans F. Combined conventional/antioxidant “Astaxanthin” treatment for male infertility: a double blind, randomized trial. Asian J Androl. 2005;7(3):257.

    Article  CAS  PubMed  Google Scholar 

  • Condorelli RA, La Vignera S, Di Bari F, Unfer V, Calogero AE. Effects of myoinositol on sperm mitochondrial function in-vitro. Eur Rev Med Pharmacol Sci. 2011;15(2):129.

    CAS  PubMed  Google Scholar 

  • Condorelli RA, La Vignera S, Bellanca S, Vicari E, Calogero AE. Myoinositol: does it improve sperm mitochondrial function and sperm motility? Urology. 2012;79(6):1290.

    Article  PubMed  Google Scholar 

  • Cooper TG, Weidner W, Nieschlag E. The influence of inflammation of the human male genital tract on secretion of the seminal markers alpha-glucosidase, glycerophosphocholine, carnitine, fructose and citric acid. Int J Androl. 1990;13(5):329.

    Article  CAS  PubMed  Google Scholar 

  • Costa M, Canale D, Filicori M, D’lddio S, Lenzi A. L-carnitine in idiopathic asthenozoospermia: a multicenter study. Italian Study Group on Carnitine and Male Infertility. Andrologia. 1994;26(3):155.

    Article  CAS  PubMed  Google Scholar 

  • Cui D, Han G, Shang Y, Liu C, Xia L, Li L, Yi S. Antisperm antibodies in infertile men and their effect on semen parameters: a systematic review and meta-analysis. Clin Chim Acta. 2015;444:29.

    Article  CAS  PubMed  Google Scholar 

  • Cyrus A, Kabir A, Goodarzi D, Moghimi M. The effect of adjuvant vitamin C after varicocele surgery on sperm quality and quantity in infertile men: a double blind placebo controlled clinical trial. Int Braz J Urol. 2015;41:230.

    Article  PubMed  PubMed Central  Google Scholar 

  • Dawson EB, Harris WA, Teter MC, Powell LC. Effect of ascorbic acid supplementation on the sperm quality of smokers. Fertil Steril. 1992;58(5):1034.

    Article  CAS  PubMed  Google Scholar 

  • De Celis R, Pedron-nuevo N, Feria-velasco A. Toxicology of male reproduction in animals and humans. Arch Androl. 1996;37:201.

    Article  PubMed  Google Scholar 

  • De Rosa M, Boggia B, Amalfi B, Zarrilli S, Vita A, Colao A, Lombardi G. Correlation between seminal carnitine and functional spermatozoal characteristics in men with semen dysfunction of various origins. Drugs R D. 2005;6(1):1.

    Article  PubMed  Google Scholar 

  • Doba T, Burton GW, Ingold KU. Antioxidant and co-antioxidant activity of vitamin C. The effect of vitamin C, either alone or in the presence of vitamin E or a water-soluble vitamin E analogue, upon the peroxidation of aqueous multilamellar phospholipid liposomes. Biochim Biophys Acta. 1985;835(2):298.

    Article  CAS  PubMed  Google Scholar 

  • Duffy DM, VandeVoort CA. Maturation and fertilization of nonhuman primate oocytes are compromised by oral administration of a cyclooxygenase-2 inhibitor. Fertil Steril. 2011;95(4):1256.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • El-Harouny MA, Zalata AA, Naser ME, Abo El-Atta HM, El-Shawaf IM, Mostafa T. Long-term ofloxacin testicular toxicity: an experimental study. Andrologia. 2010;42(2):92.

    Article  CAS  PubMed  Google Scholar 

  • ElSheikh MG, Hosny MB, Elshenoufy A, Elghamrawi H, Fayad A, Abdelrahman S. Combination of vitamin E and clomiphene citrate in treating patients with idiopathic oligoasthenozoospermia: a prospective randomized trial. Andrology. 2015;3:864–7.

    Article  CAS  PubMed  Google Scholar 

  • Eskenazi B, Kidd SA, Marks AR, Sloter E, Block G, Wyrobek AJ. Antioxidant intake is associated with semen quality in healthy men. Hum Reprod. 2005;20(4):1006.

    Article  CAS  PubMed  Google Scholar 

  • Farombi EO, Ugwuezunmba MC, Ezenwadu TT, Oyeyemi MO, Ekor M. Tetracycline-induced reproductive toxicity in male rats: effects of vitamin C and N-acetylcysteine. Exp Toxicol Pathol. 2008;60(1):77.

    Article  CAS  PubMed  Google Scholar 

  • Fisher HM, Aitken RJ. Comparative analysis of the ability of precursor germ cells and epididymal spermatozoa to generate reactive oxygen metabolites. J Exp Zool. 1997;277:390.

    Article  CAS  PubMed  Google Scholar 

  • Frei B, England L, Ames BN. Ascorbate is an outstanding antioxidant in human blood plasma. Proc Natl AcadSci USA. 1989;86(16):6377.

    Article  CAS  Google Scholar 

  • Fujii J, Iuchi Y, Matsuki S, Ishii T. Cooperative function of antioxidant and redox systems against oxidative stress in male reproductive tissues. Asian J Androl. 2003;5(3):231.

    CAS  PubMed  Google Scholar 

  • Gambera L, Serafini F, Morgante G, Focarelli R, De Leo V, Piomboni P. Sperm quality and pregnancy rate after COX-2 inhibitor therapy of infertile males with abacterial leukocytospermia. Hum Reprod. 2007;22(4):1047.

    Article  CAS  PubMed  Google Scholar 

  • Geva E, Bartoov B, Zabludovsky N, Lessing JB, Lerner-Geva L, Amit A. The effect of antioxidant treatment on human spermatozoa and fertilization rate in an in vitro fertilization program. Fertil Steril. 1996;66(3):430.

    Article  CAS  PubMed  Google Scholar 

  • Ghanem H, Shaeer O, El-Segini A. Combination clomiphene citrate and antioxidant therapy for idiopathic male infertility: a randomized controlled trial. Fertil Steril. 2010;93:2232.

    Article  CAS  PubMed  Google Scholar 

  • Giovenco P, Amodei M, Barbieri C, Fasani R, Carosi M, Dondero F. Effects of kallikrein on the male reproductive system and its use in the treatment of idiopathic oligozoospermia with impaired motility. Andrologia. 1987;19:238.

    Article  PubMed  Google Scholar 

  • Gomez E, Buckingham DW, Brindle J, Lanzafame F, Irvine DS, Aitken RJ. Development of an image analysis system to monitor the retention of residual cytoplasm by human spermatozoa: correlation with biochemical markers of the cytoplasmic space, oxidative stress, and sperm function. J Androl. 1996;17:276.

    CAS  PubMed  Google Scholar 

  • Grabe M, Bjerklund-Johansen TE, Botto H et al. Guidelines on urological infections. Eur Assoc Urol; 2013. Available at: http://uroweb.org/wp-content/uploads/18_Urological-infections_LR.pdf.

  • Greco E, Iacobelli M, Rienzi L, Ubaldi F, Ferrero S, Tesarik J. Reduction of the incidence of sperm DNA fragmentation by oral antioxidant treatment. J Androl. 2005a;26(3):349.

    Article  CAS  PubMed  Google Scholar 

  • Greco E, Romano S, Iacobelli M, Ferrero S, Baroni E, Minasi MG, Ubaldi F, Rienzi L, Tesarik J. ICSI in cases of sperm DNA damage: beneficial effect of oral antioxidant treatment. Hum Reprod. 2005b;20(9):2590.

    Article  CAS  PubMed  Google Scholar 

  • Gulino FA, Leonardi E, Marilli I, Musmeci G, Vitale SG, Leanza V, Palumbo MA. Effect of treatment with myo-inositol on semen parameters of patients undergoing an IVF cycle: in vivo study. Gynecol Endocrinol. 2016;32(1):65.

    Article  CAS  PubMed  Google Scholar 

  • Gvozdjáková A, Kucharská J, Dubravicky J, Mojto V, Singh RB. Coenzyme Q10, α-tocopherol, and oxidative stress could be important metabolic biomarkers of male infertility. Dis Markers. 2015; 827941.

    Google Scholar 

  • Hargreave TB, Kyle KF, Baxby K, Rogers AC, Scott R, Tolley DA, Abel BJ, Orr PS, Elton RA. Randomised trial of mesterolone versus vitamin C for male infertility. Scottish Infertility Group. Br J Urol. 1984;56:740–4.

    Article  CAS  PubMed  Google Scholar 

  • Jacob RA, Pianalto FS, Agee RE. Cellular ascorbate depletion in healthy men. J Nutr. 1992;122(5):1111.

    CAS  PubMed  Google Scholar 

  • Jung JH, Seo JT. Empirical medical therapy in idiopathic male infertility: Promise or panacea? Clin Exp Reprod Med. 2014;41(3):108.

    Article  PubMed  PubMed Central  Google Scholar 

  • Kennedy JH, Korn N, Thurston RJ. Prostaglandin levels in seminal plasma and sperm extracts of the domestic turkey, and the effects of cyclooxygenase inhibitors on sperm mobility. Reprod Biol Endocrinol. 2003;1:74.

    Article  PubMed  PubMed Central  Google Scholar 

  • Kessopoulou E, Powers HJ, Sharma KK, Pearson MJ, Russel JM, CookeI D, Barrat CL. A double–blind randomized placebo cross–over controlled trial using the antioxidant vitamin E to treat reactive oxygen species associated male infertility. Fertil Steril. 1995;64(4):825.

    Article  CAS  PubMed  Google Scholar 

  • La Vignera S, Condorelli RA, Vicari E, Tumino D, Morgia G, Favilla V, Cimino S, Calogero AE. Markers of semen inflammation: supplementary semen analysis? J Reprod Immunol. 2013;100(1):2.

    Article  PubMed  CAS  Google Scholar 

  • La Vignera S, Condorelli RA, Vicari E, Salmeri M, Morgia G, Favilla V, Cimino S, Calogero AE. Microbiological investigation in male infertility: a practical overview. J Med Microbiol. 2014;63:1.

    Article  PubMed  Google Scholar 

  • La Vignera S, Vicari E, Condorelli RA, Franchina C, Scalia G, Morgia G, Perino A, Schillaci R, Calogero AE. Prevalence of human papilloma virus infection in patients with male accessory gland infection. Reprod BioMed Online. 2015;30(4):385.

    Article  PubMed  Google Scholar 

  • Lackner JE, Herwig R, Schmidbauer J, Schatzl G, Kratzik C, Marberger M. Correlation of leukocytospermia with clinical infection and the positive effect of antiinflammatory treatment on semen quality. Fertil Steril. 2006;86(3):601.

    Article  PubMed  Google Scholar 

  • Lafuente R, Gonzàlez-Comadràn M, Solà I, Lòpez G, Brassesco M, Carreras R, Checa MA. Coenzyme Q10 and male infertility: a meta-analysis. J Assist Reprod Genet. 2013;30:1147.

    Article  PubMed  PubMed Central  Google Scholar 

  • Lahdetie J. Occupation- and exposure-related studies on human sperm. J Occup Environ Med. 1995;37:922.

    Article  CAS  PubMed  Google Scholar 

  • Lancaster JW, Mahoney MV, Mandal S, Lawrence KR. Update on Treatment Options for Gonococcal Infections. Pharmacotherapy. 2015;35(9):856.

    Article  PubMed  Google Scholar 

  • Lanzafame FM, La Vignera S, Vicari E, Calogero AE. Oxidative stress and medical antioxidant treatment in male infertility. Reprod BioMed Online. 2009;19(5):638.

    Article  CAS  PubMed  Google Scholar 

  • Lenzi A, Lombardo F, Gandini L, Dondero F. Metabolism and action of L-carnitine: its possible role in sperm tail function. Arch Ital Urol Nefrol Androl. 1992;64(2):187.

    CAS  PubMed  Google Scholar 

  • Lenzi A, Culasso F, Gandini L, Lombardo F, Dondero F. Placebo-controlled, double-blind, cross-over trial of glutathione therapy in male infertility. Hum Reprod. 1993;8(10):1657.

    Article  CAS  PubMed  Google Scholar 

  • Lenzi A, Picardo M, Gandini L, Lombardzo F, Terminali O, Passi S, Dondero F. Glutathione treatment of dyspermia: effect on the lipoperoxidation process. Hum Reprod. 1994;9(11):2044.

    Article  CAS  PubMed  Google Scholar 

  • Lenzi A, Lombardo F, Sgrò P, Salacone P, Caponecchia L, Dondero F, Gandini L. Use of carnitine therapy in selected cases of male factor infertility: a double-blind crossover trial. Fertil Steril. 2003;79(2):292.

    Article  PubMed  Google Scholar 

  • Lenzi A, Sgrò P, Salacone P, Paoli D, Gilio B, Lombardo F, Santulli M, Agarwal A, Gandini L. A placebo-controlled double-blind randomized trial of the use of combined l-carnitine and l-acetyl-carnitine treatment in men with asthenozoospermia. Fertil Steril. 2004;81(6):1578.

    Article  CAS  PubMed  Google Scholar 

  • Levine M, Conry-Cantilena C, Wang Y, Welch RW, Washko PW, Dhariwal KR, Park JB, Lazarev A, Graumlich JF, King J, Cantilena LR. Vitamin C pharmacokinetics in healthy volunteers: evidence for a recommended dietary allowance. Proc Natl Acad Sci USA. 1996;93(8):3704.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Li Z, Chen GW, Shang XJ, Bai WJ, Han YF, Chen B, Teng XM, Meng FH, Zhang B, Chen DN, Liu JH, Zheng XM, Cao XR, Liu Y, Zhu XB, Wang YX. A controlled randomized trial of the use of combinated L-carnitine and acetyl-L-carnitine treatment in men with oligoasthenozoospermia. Zhonghua Nan KeXue. 2005;11:761–4.

    Google Scholar 

  • Magri V, Marras E, Skerk V, et al. Eradication of Chlamydia trachomatis parallels symptom regression in chronic bacterial prostatitis patients treated with a fluoroquinolone-macrolide combination. Andrologia. 2010;42:366.

    Article  CAS  PubMed  Google Scholar 

  • Magri V, Montanari E, Skerk V, et al. Fluoroquinolone-macrolide combination therapy for chronic bacterial prostatitis: retrospective analysis of pathogen eradication rates, inflammatory findings and sexual dysfunction. Asian J Androl. 2011;13:819.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Makker K, Agarwal A, Sharma R. Oxidative stress & male infertility. Indian J Med Res. 2009;129(4):357.

    CAS  PubMed  Google Scholar 

  • Mancini A, Conte G, Milardi D, de Marinis L, Littarru GP. Relationship between sperm cell ubiquinone and seminal parameters in subjects with and without varicocele. Andrologia. 1998;30(1):1.

    Article  CAS  PubMed  Google Scholar 

  • Manson JM, Zolna LE, Kang YJ, Johnson CM. Effects of cefonicid and other cephalosporin antibiotics on male sexual development in rats. Antimicrob Agents Chemother. 1987;31(7):991.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Milardi D, Luca G, Grande G, Ghezzi M, Caretta N, Brusco G, De Filpo G, Marana R, Pontecorvi A, Calafiore R, Foresta C, Garolla A. Prednisone treatment in infertile patients with oligozoospermia and accessory gland inflammatory alterations Andrology. 2017;5(2):268.

    Google Scholar 

  • Mishra M, Acharya UR. Protective action of vitamins on the spermatogenesis in lead-treated Swiss mice. J Trace Elem Med Biol. 2004;18(2):173.

    Article  CAS  PubMed  Google Scholar 

  • Moilanen J, Hovatta O. Excretion of alpha-tocopherol into human seminal plasma after oral administration. Andrologia. 1995;27(3):133.

    Article  CAS  PubMed  Google Scholar 

  • Moilanen J, Hovatta O, Lindroth L. Vitamin E levels in seminal plasma can be elevated by oral administration of vitamin E in infertile men. Int J Androl. 1993;16(2):165.

    Article  CAS  PubMed  Google Scholar 

  • Moncada ML, Vicari E, Cimino C, Calogero AE, Mongioì A, D'Agata R. Effect of acetylcarnitine treatment in oligoasthenospermicpatients. Acta Eur Fertil. 1992;23(5):221.

    CAS  PubMed  Google Scholar 

  • Mortazavi M, Salehi I, Alizadeh Z, Vahabian M, Roushandeh AM. Protective effects of antioxidants on sperm parameters and seminiferous tubules epithelium in high fat-fed rats. J Reprod Infertil. 2014;15(1):22.

    CAS  PubMed  PubMed Central  Google Scholar 

  • Nadjarzadeh A, Sadeghi MR, Amirjannati N, Vafa MR, Motevalian SA, Ohari MR, Akhondi MA, Yavari P, Shidfar F. Coenzyme Q10 improves seminal oxidative defense but does not affect on semen parameters in idiopathic oligoasthenozoospermia: a randomized double-blind, placebo cotrolled trial. J Endocrinol Investig. 2011;34:224–8.

    Google Scholar 

  • Nadjarzadeh A, Shidfar F, Amirjannati N, Vafa MR, Motevalian SA, Gohari MR, NazeriKakhki SA, Akhondi MM, Sadeghi MR. Effect of Coenzyme Q10 supplementation on antioxidant enzymes activity and oxidative stress of seminal plasma: a double-blind randomized clinical trial. Andrologia. 2014;46:177–83.

    Article  CAS  PubMed  Google Scholar 

  • Naz RK. Modalities for treatment of antisperm antibody mediated infertility: novel perspectives. Am J Reprod Immunol. 2004;51(5):390.

    Article  PubMed  Google Scholar 

  • Ng CM, Blackman MR, Wang C, Swerdloff RS. The role of carnitine in the male reproductive system. Ann N Y Acad Sci. 2004;1033:177.

    Article  CAS  PubMed  Google Scholar 

  • Oh MM, Chae JY, Kim JW, Kim JW, Yoon CY, Park MG, Moon du G. Positive culture for extended-spectrum β-lactamase during acute prostatitis after prostate biopsy is a risk factor for progression to chronic prostatitis. Urology. 2013;81(6):1209.

    Article  PubMed  Google Scholar 

  • Opuwari CS, Henkel RR. An update on oxidative damage to spermatozoa and oocytes. Biomed Res Int. 2016;2016(9540142).

    Google Scholar 

  • Perletti G, Marras E, Wagenlehner FM, Magri V. Antimicrobial therapy for chronic bacterial prostatitis Cochrane Database Syst Rev. 2013;(8) CD009071.

    Google Scholar 

  • Porat-Soldin O, Soldin SJ. Preliminary studies on the in vitro and in vivo effect of salicylate on sperm motility. Ther Drug Monit. 1992;14(5):366.

    Article  CAS  PubMed  Google Scholar 

  • Rees J, Abrahams M, Doble A, Cooper A. Prostatitis Expert Reference Group (PERG). Diagnosis and treatment of chronic bacterial prostatitis and chronic prostatitis/chronic pelvic pain syndrome: a consensus guideline. BJU Int. 2015;116(4):509–25.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Rolf C, Cooper TG, Yeung CH, Nieschlag E. Antioxidant treatment of patients with asthenozoospermia or moderate oligoasthenospermia with high-dose vitamin C and vitamin E: a randomized, placebo-controlled, double-blind study. Hum Reprod. 1999;14:1028–33.

    Article  CAS  PubMed  Google Scholar 

  • Roodbari F, Abedi N, Talebi AR. Early and late effects of Ibuprofen on mouse sperm parameters, chromatin condensation, and DNA integrity in mice. Iran J Reprod Med. 2015;13(11):703.

    PubMed  PubMed Central  Google Scholar 

  • Rubino P, Palini S, Chigioni S, Carlomagno G, Quagliarello A, De Stefani S, Baglioni A, Bulletti C. Improving fertilization rate in ICSI cycles by adding myoinositol to the semen preparation procedures: a prospective, bicentric, randomized trial on sibling oocytes. J Assist Reprod Genet. 2015;32:387–94.

    Article  PubMed  PubMed Central  Google Scholar 

  • Safarinejad MR. Efficacy of coenzyme Q10 on semen parameters, sperm function and reproductive hormones in infertile men. J Urol. 2009;182(1):237.

    Article  CAS  PubMed  Google Scholar 

  • Safarinejad MR. The effect of coenzyme Q10 supplementation on partner pregnancy rate in infertile men with idiopathic oligoasthenoteratozoospermia: an open-label prospective study. Int Urol Nephrol. 2012;44(3):689.

    Article  CAS  PubMed  Google Scholar 

  • Safarinejad MR, Safarinejad S. Efficacy of selenium and/or N-acetyl-cysteine for improving semen parameters in infertile men: a double-blind, placebo controlled, randomized study. J Urol. 2009;181(2):741–51.

    Article  CAS  PubMed  Google Scholar 

  • Sharma RK, Kalla NR. Spermatozoal abnormalities and male infertility in the rat following sulfasalazine treatment. Int J Fertil Menopausal Stud. 1994;39(6):347.

    CAS  PubMed  Google Scholar 

  • Shin T, Kobori Y, Suzuki K, Iwahata T, Yagi H, Soh S, Arai G, Okada H. Inflammatory bowel disease in subfertile men and the effect of mesalazine on fertility. Syst Biol Reprod Med. 2014;60(6):373.

    Article  CAS  PubMed  Google Scholar 

  • Showell MG, Mackenzie-Proctor R, Brown J, Yazdani A, Stankiewicz MT, Hart RJ. Antioxidants for male subfertility. Cochrane Database Syst Rev. 2014; (12). CD007411.

    Google Scholar 

  • da Silva RF, dos Santos Borges C, Villela P, Villela S, Missassi G, Kiguti LRA, Pupo AS, Barbosa FJ, Anselmo-Franci JA, De Grava Kempinas W. The Coadministration of N-acetylcysteine ameliorates the effects of arsenic trioxide on the male mouse genital system. Oxid Med Cell Longev. 2016; 4257498.

    Google Scholar 

  • Singh AC, Kumar M, Jha AM. Genotoxicity of lomefloxacin--an antibacterial drug in somatic and germ cells of Swiss albino mice in vivo. Mutat Res. 2003;535(1):35.

    Article  CAS  PubMed  Google Scholar 

  • Singh RP, Sastry KV, Dubey PK, Agrawal R, Singh R, Pandey NK, Mohan J. Norfloxacin drug induces reproductive toxicity and alters androgen receptor gene expression in testes and cloacal gland of male Japanese quail (Coturnix japonica). Environ Toxicol Chem. 2013;32(9):2134.

    Article  CAS  PubMed  Google Scholar 

  • Skerk V, Scheonwald S, Krhen I, et al. Comparative analysis of azithromycin and clarithromycin efficacy and tolerability in the treatment of chronic prostatitis caused by Chlamydia trachomatis. J Chemother. 2002;14:384.

    Article  CAS  PubMed  Google Scholar 

  • Skerk V, Schönwald S, Krhen I, Banaszak A, Begovac J, Strugar J, Strapac Z, Vrsalovic R, Vukovic J, Tomas M. Comparative analysis of azithromycin and ciprofloxacin in the treatment of chronic prostatitis caused by Chlamydia trachomatis. Int J Antimicrob Agents. 2003;21:457.

    Article  CAS  PubMed  Google Scholar 

  • Skerk V, Krhen I, Lisi M, Krhen I, Lisić M, Begovac J, Roglić S, Skerk V, Sternak SL, Banaszak A, Strugar-Suica J, Vuković J. Comparative randomized pilot study of azithromycin and doxycycline efficacy in the treatment of prostate infection caused by Chlamydia trachomatis. Int J Antimicrob Agents. 2004;24:188.

    Article  CAS  PubMed  Google Scholar 

  • Slowikowska-Hilczer J. Xenobiotics with estrogen or antiandrogen action – disruptors of the male reproductive system. CEJM. 2006;3:205.

    Google Scholar 

  • Song GJ, Norkus EP, Lewis V. Relationship between seminal ascorbic acid and sperm DNA integrity in infertile men. Int J Androl. 2006;29(6):569.

    Article  CAS  PubMed  Google Scholar 

  • Suleiman SA, Ali ME, Zaki ZM, el-Malik EM, Nasr MA. Lipid peroxidation and human sperm motility: protective role of vitamin E. J Androl. 1996;17(5):530.

    CAS  PubMed  Google Scholar 

  • Thérond P, Auger J, Legrand A, Jouannet P. Alpha-Tocopherol in human spermatozoa and seminal plasma: relationships with motility, antioxidant enzymes and leukocytes. Mol Hum Reprod. 1996;2(10):739.

    Article  PubMed  Google Scholar 

  • Thiele JJ, Friesleben HJ, Fuchs J, Ochsendorf FR. Ascorbic acid and urate in human seminal plasma: determination and interrelationships with chemiluminescence in washed semen. Hum Reprod. 1995;10(1):110.

    Article  CAS  PubMed  Google Scholar 

  • Thonneau P, Bujan L, Multigner L, Mieusset R. Occupational heat exposure and male fertility: a review. Hum Reprod. 1998;13:2122.

    Article  CAS  PubMed  Google Scholar 

  • Tripodi L, Tripodi A, Mammí C, Pullé C, Cremonesi F. Pharmacological action and therapeutic effects of glutathione on hypokinetic spermatozoa for enzymatic-dependent pathologies and correlated genetic aspects. Clin Exp Obstet Gynecol. 2003;30(2–3):130.

    CAS  PubMed  Google Scholar 

  • Ugochukwu AP, Ebere OO, Okwuoma A. Effects of nimesulide on testicular functions in prepubertal albino rats. J Basic Clin Physiol Pharmacol. 2011;22(4):137.

    Article  CAS  PubMed  Google Scholar 

  • Vargas A, Bustos-Obregón E, Hartley R. Effects of hypoxia on epididymal sperm parameters and protective role of ibuprofen and melatonin. Biol Res. 2011;44(2):161.

    Article  CAS  PubMed  Google Scholar 

  • Vicari E, Calogero AE. Effects of treatment with carnitines in infertile patients with prostato-vesiculo-epididymitis. Hum Reprod. 2001;16(11):2338.

    Article  CAS  PubMed  Google Scholar 

  • Vicari E, Rubino C, De Palma A, Longo G, Lauretta M, Consoli S, Arancio A. Antioxidant therapeutic efficiency after the use of carnitine in infertile patients with bacterial or non-bacterial prostato-vesiculo-epididymitis. Arch Ital Urol Androl. 2001;73(1):15.

    CAS  PubMed  Google Scholar 

  • Vicari E, La Vignera S, Calogero AE. Antioxidant treatment with carnitines is effective in infertile patients with prostatovesiculoepididymitis and elevated seminal leukocyte concentrations after treatment with nonsteroidal anti-inflammatory compounds. Fertil Steril. 2002;78(6):1203.

    Article  PubMed  Google Scholar 

  • Vitali G, Parente R, Melotti C. Carnitine supplementation in human idiopathic asthenospermia: clinical results. Drugs Exp Clin Res. 1995;21(4):157.

    CAS  PubMed  Google Scholar 

  • Walczak-Jedrzejowska R, Wolski JK, Slowikowska-Hilczer J. The role of oxidative stress and antioxidants in male fertility. Cent European J Urol. 2013;66(1):60.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Wayner DD, Burton GW, Ingold KU. The antioxidant efficiency of vitamin C is concentration-dependent. Biochim Biophys Acta. 1986;884(1):119.

    Article  CAS  PubMed  Google Scholar 

  • Wen Y, Cooke T, Feely J. The effect of pharmacological supplementation with vitamin C on low-density lipoprotein oxidation. Br J Clin Pharmacol. 1997;44(1):94.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Wolfson JS, Hooper DC. Pharmacokinetics of quinolones: newer aspects. Eur J Clin Microbiol Infect Dis. 1991;10(4):267.

    Article  CAS  PubMed  Google Scholar 

  • World Health Organization. WHO Laboratory Manual for the Examination and Processing of Human Semen. 5th ed. Geneva: World Health Organization; 2010.

    Google Scholar 

  • Yanushpolsky EH, Politch JA, Hill JA, Anderson DJ. Is leukocytospermia clinically relevant? Fertil Steril. 1996;66(5):822.

    Article  CAS  PubMed  Google Scholar 

  • Zhang ZC, Jin FS, Liu DM, Shen ZJ, Sun YH, Guo YL. Safety and efficacy of levofloxacin versus ciprofloxacin for the treatment of chronic bacterial prostatitis in Chinese patients. Asian J Androl. 2012;14:870.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Aldo E. Calogero .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2017 Springer International Publishing AG

About this entry

Cite this entry

Calogero, A.E., Condorelli, R.A., La Vignera, S. (2017). Nonhormonal Medical Treatment of Male Infertility. In: Simoni, M., Huhtaniemi, I. (eds) Endocrinology of the Testis and Male Reproduction. Endocrinology. Springer, Cham. https://doi.org/10.1007/978-3-319-29456-8_37-1

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-29456-8_37-1

  • Received:

  • Accepted:

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-29456-8

  • Online ISBN: 978-3-319-29456-8

  • eBook Packages: Springer Reference MedicineReference Module Medicine

Publish with us

Policies and ethics