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

Abstract

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.

Do proton pump inhibitors harm to semen? Hyderabad Sindh based study

“…In another study, the investigators included 40 sub fertile men taking medication for gastric acid related symptoms and compared the semen parameter to control. No signifi cant difference was found in semen parameters between cases and controls [18]. Which is matched to our study in which only semen volume signifi cantly decreased p 0.05.…”

Omeprazole does not alter human sperm motility, viability or DNA integrity in vitro

“…Later study on male mice, in 2002, demonstrated that omeprazole did not induce the increase in diploid or disomic sperm (Adler, Schmid, & Baumgartner, ). A very recent retrospective data review on 248 subfertile men who used proton pump inhibitors for at least 3 months before semen collection concluded that, in general, proton pump inhibitors, including omeprazole, did not associate with determinantal effects on semen quality (Keihani et al, ). Alternatively, seminal Helicobacter pylori treatment (500 mg tinidazole, 250 mg clarithromycin and 20 mg omeprazole) twice a day, for 14 days, was found to improve progressive and total sperm motility in asthenozoospermic males (Caviglia, Fagoonee, & Pellicano, ; El‐Garem, El‐Sawy, & Mostafa, ).…”

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

“…Only two recent studies investigated the effect of PPI intake in a period > 3 months preceding semen analysis on human semen quality. The results were clearly contradictory, the first showing that the use of PPIs is associated with a threefold higher risk of low total motile sperm count, 41 whereas the second has shown PPI use was not associated with detrimental effects on conventional semen parameters in subfertile patients 42 . However, these studies revealed only one facet of sperm inhibition by PPIs.…”

“…The results were clearly contradictory, the first showing that the use of PPIs is associated with a threefold higher risk of low total motile sperm count, 41 whereas the second has shown PPI use was not associated with detrimental effects on conventional semen parameters in subfertile patients. 42 However, these studies revealed only one facet of sperm inhibition by PPIs. Spermatozoa can indeed be modulated either in the male by PPIs while they are produced in the testis or stored in the epididymis or in the female when they are located in the uterus and oviduct.…”