Effect of Medications for Gastric Acid-Related Symptoms on Total Motile Sperm Count and Concentration: A Case-Control Study in Men of Subfertile Couples from the Netherlands.

Autor: Huijgen NA; Department of Obstetrics and Gynaecology, University Medical Centre, Erasmus MC, Rotterdam, The Netherlands., Goijen HJ; Department of Obstetrics and Gynaecology, University Medical Centre, Erasmus MC, Rotterdam, The Netherlands., Twigt JM; Department of Obstetrics and Gynaecology, University Medical Centre, Erasmus MC, Rotterdam, The Netherlands., Mulders AG; Department of Obstetrics and Gynaecology, University Medical Centre, Erasmus MC, Rotterdam, The Netherlands., Lindemans J; Department of Clinical Chemistry, University Medical Centre, Erasmus MC, Rotterdam, The Netherlands., Dohle GR; Andrology Unit, Department of Urology, University Medical Centre, Erasmus MC, Rotterdam, The Netherlands., Laven JS; Division of Reproductive Medicine, Department of Obstetrics and Gynaecology, University Medical Centre, Erasmus MC, Rotterdam, The Netherlands., Steegers-Theunissen RP; Department of Obstetrics and Gynaecology, University Medical Centre, Erasmus MC, Rotterdam, The Netherlands. r.steegers@erasmusmc.nl.; Division of Neonatology, Department of Pediatrics, University Medical Centre, Erasmus MC, Dr. Molewaterplein 50, 3000 DR, Rotterdam, The Netherlands. r.steegers@erasmusmc.nl.
Jazyk: angličtina
Zdroj: Drug safety [Drug Saf] 2017 Mar; Vol. 40 (3), pp. 241-248.
DOI: 10.1007/s40264-016-0488-8
Abstrakt: Introduction: Gastric acid-related symptoms are highly prevalent in the general population (21-40%), and more than 11% of individuals use medication for the treatment of these symptoms. The uptake of micronutrients is dependent on the gastrointestinal potential of hydrogen (pH).
Objective: We hypothesized that medication affecting gastrointestinal pH reduces the availability of B vitamins, thereby deranging one-carbon metabolism and detrimentally affecting spermatogenesis.
Methods: This explorative nested case-control study in men of subfertile couples investigated associations between medication used for gastric acid-related symptoms and semen parameters. We included 40 men using medication for gastric acid-related symptoms and 843 men not using medication. Semen analyses were performed between 70 days before and 21 days after the visit.
Results: The use of medication was associated with a twofold higher risk of a low total motile sperm count [TMSC <1 × 10 6 , odds ratio (OR) 2.090, p = 0.049] and negatively with sperm concentration (β -0.320, p = 0.028). Red blood cell folate was positively associated with TMSC (β 0.257, p = 0.026), sperm count (β 1.679, p = 0.013) and ejaculate volume (β 0.120, p = 0.023), and total homocysteine (tHcy) was negatively associated with sperm count (β -0.077, p = 0.021).
Conclusion: Here we delineate associations between the use of medication for gastric acid-related symptoms and poor semen quality in men of subfertile couples. The use of medication for gastric acid-related symptoms is associated with a twofold higher risk of a low TMSC and a decreased sperm concentration. Although these findings warrant further research on causality, the associations between folate, tHcy and semen quality emphasize the importance of preconception counselling in male subfertility.
Databáze: MEDLINE
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