Pantoprazole, a proton-pump inhibitor, impairs human sperm motility and capacitation in vitro

BACKGROUND

The effects of PPIs on human sperm fertilizing capacity were poorly investigated although these drugs are widely over-used. Two publications retrospectively studied relationships between any PPI intake and sperm parameters from patients consulting at infertility clinics, but the conclusions of these reports were contradictory. Only two reports investigated the effects of lansoprazole and omeprazole on sperm motility and found lansoprazole to be deleterious and omeprazole to be neutral for sperm motility. The inconsistency of the PPI effect in the previous reports emphasizes the need for more basic research on human spermatozoa, taking into account the hypothesis that the different PPI drugs may have different effects on sperm physiology.

OBJECTIVES

Do PPIs, which are among the most widely sold drug in the word, impact negatively human sperm capacitation and sperm motility?

MATERIALS AND METHODS

The effects of PPIs on human sperm maturation and motility were analyzed by CASA, flow cytometry, and Western blot.

RESULTS

We tested the impact of 6 different PPIs on human sperm motility and capacitation. We showed that pantoprazole, but not the other PPIs, decreased sperm progressive motility and capacitation-induced sperm hyperactivation. We therefore investigated further the effects of pantoprazole on sperm capacitation, and we observed that it had a significant deleterious effect on the capacitation-induced hyperpolarization of the membrane potential and capacitation-associated protein phosphorylation.

DISCUSSION AND CONCLUSION

Our results indicate that exposure to pantoprazole has an adverse effect on the physiological competence of human spermatozoa. As the capacitation process takes place within the female tract, our results suggest that PPIs intake by the female partner may impair in vivo sperm maturation and possibly fertilization. Moreover, the absence of adverse effect by PPIs on mouse sperm emphasizes the need to develop reprotox assays using human material to better assess the effects of medication intake on sperm physiology.

Seminal plasma vitamin B6 levels in men with asthenozoospermia and men with normal sperm motility, a measurement using liquid chromatography with tandem mass spectrometry

There is growing evidence that vitamin B₆ has a valuable contribution in maintaining normal sperm parameters; however, this contribution has not yet well-identified. Here, we aimed to measure the level of seminal plasma vitamin B₆ in men with asthenozoospermia compared to men with normal sperm motility. Ninety-seven human males with asthenozoospermia and eighty-eight human males with normal sperm motility (control) were recruited in this study. Collected semen samples were assessed for sperm motility, sperm count and semen volume. Liquid chromatography with tandem mass spectrometry was used to measure seminal plasma vitamin B₆ concentrations. A highly significant difference (p < .0001) in concentrations of seminal plasma vitamin B₆ was found between asthenozoospermic and control groups. Besides, no statistical correlations were found between seminal plasma vitamin B₆ level and sperm motility, sperm count, semen volume and men age in both tested groups. In conclusion, men with asthenozoospermia have lower seminal plasma vitamin B₆ level compared to men with normal sperm motility. Also, seminal plasma vitamin B₆ was found not to be correlated with sperm motility and count, semen volume and men age in both tested groups. These results may provide new contribution in the management of male infertility.

Proton-pump inhibitor use does not affect semen quality in subfertile men

Proton-pump inhibitors (PPIs) are among the most widely used drugs worldwide. PPI use has recently been linked to adverse changes in semen quality in healthy men; however, the effects of PPI use on semen parameters remain largely unknown specifically in cases with male factor infertility. We examined whether PPI use was associated with detrimental effects on semen parameters in a large population of subfertile men. We retrospectively reviewed data from 12 257 subfertile men who had visited our fertility clinic from 2003 to 2013. Patients who reported using any PPIs for >3 months before semen sample collection were included; 7698 subfertile men taking no medication served as controls. Data were gathered on patient age, medication use, and conventional semen parameters; patients taking any known spermatotoxic medication were excluded. Linear mixed-effect regression models were used to test the effect of PPI use on semen parameters adjusting for age. A total of 248 patients (258 samples) used PPIs for at least 3 months before semen collection. In regression models, PPI use (either as the only medication or when used in combination with other nonspermatotoxic medications) was not associated with statistically significant changes in semen parameters. To our knowledge, this is the largest study to compare PPI use with semen parameters in subfertile men. Using PPIs was not associated with detrimental effects on semen quality in this retrospective study.

Effect of lansoprazole on human sperm motility, sperm viability, seminal nitric oxide production, and seminal calcium chelation

Lansoprazole is a proton-pump inhibitor that is commonly used to treat many gastric illnesses. However, little is known about its effect on sperm function. Here, we investigated the in vitro effect of LP on human sperm motility, viability, nitric oxide (NO) production, and the ability of LP to chelate seminal calcium. Seventy-two semen samples from normozoospermic men were tested in this study. The effects of LP at 0.375, 0.75, 1.5, and 3 μg/mL on sperm motility and viability as well as at 3 μg/mL on NO production and calcium chelation in semen were assessed. Lansoprazole at 3 μg/mL significantly decreased total and progressive sperm motility (P = 0.0021, P = 0.0256, respectively), but not sperm viability (P = 0.8763). In addition, semen samples supplemented with 3 μg/mL LP had insignificant changes (P = 0.9085) in nitrite concentrations. Moreover, LP exhibited a significant (P < 0.0001) calcium chelation effect in semen. In conclusion, LP reduced sperm motility, but not viability. The reduction in sperm motility may be due to the calcium chelating effect of LP and/or decreased Na⁺/K⁺-ATPase activity, but not an alteration in NO production. Besides, none of the tested parameters was found to be correlated with male age.