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非激素药物治疗男性不育症的进展:肌醇的作用。

Advances in non-hormonal pharmacotherapy for the treatment of male infertility: the role of inositols.

机构信息

Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy.

Department of Drug and Health Sciences, University of Catania, Catania, Italy.

出版信息

Expert Opin Pharmacother. 2022 Jun;23(9):1081-1090. doi: 10.1080/14656566.2022.2060076. Epub 2022 Apr 3.

Abstract

INTRODUCTION

Several antioxidants are available for the treatment of male infertility. Although the benefit of myo-inositol (MYO) and D-chiro-inositol (DCI) for female infertility is recognized, their role in male infertility is a matter of debate.

AREAS COVERED

The authors review the impact that treatment with MYO and/or DCI may have on conventional and bio-functional sperm parameters [mitochondrial membrane potential (MMP), sperm chromatin compactness, and sperm DNA fragmentation (SDF)], seminal oxidative stress (OS), and pregnancy, miscarriage, and live birth rates, and the possible mechanisms involved. Furthermore, the authors gather evidence on the effects of MYO and/or DCI on sperm function .

EXPERT OPINION

MYO can improve sperm count, motility, capacitation, acrosome reaction, and MMP. No data are currently available on the effects of DCI . Both MYO and DCI ameliorate sperm motility and MMP . Therefore, the use of inositols should be preferred in patients with idiopathic asthenozoospermia, especially in case of impaired sperm mitochondrial function. Due to their insulin-sensitizing action, a role for these molecules may be envisaged for the treatment of infertility caused by carbohydrate metabolism derangement.

摘要

简介

有几种抗氧化剂可用于治疗男性不育症。虽然已确认肌醇(MYO)和 D-手性肌醇(DCI)对女性不孕的有益作用,但它们在男性不育中的作用仍存在争议。

涵盖领域

作者综述了 MYO 和/或 DCI 治疗对常规和生物功能精子参数(线粒体膜电位(MMP)、精子染色质致密性和精子 DNA 碎片化(SDF))、精液氧化应激(OS)以及妊娠、流产和活产率的影响,以及可能涉及的相关机制。此外,作者还收集了关于 MYO 和/或 DCI 对精子功能影响的证据。

专家意见

MYO 可以提高精子数量、活力、获能、顶体反应和 MMP。目前尚无关于 DCI 影响的数据。MYO 和 DCI 均可改善精子活力和 MMP。因此,在特发性弱精子症患者中,应优先使用肌醇,尤其是在精子线粒体功能受损的情况下。由于它们具有胰岛素增敏作用,这些分子在治疗因碳水化合物代谢紊乱引起的不育症方面可能具有作用。

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