Theophylline and Zinc Sulfate Co-administration improves the Sperm Parameters in Asthenoteratozoospermic Patients: A Double-blind, Randomized Clinical Trial Study

Research question: Theophylline can improve sperm quality in patients but also causes sperm DNA fragmentation. The question is “does co-administration of zinc sulfate and theophylline reduce DNA fragmentation in asthenoteratozoospermia men?”
Design: One hundred and twenty asthenoteratozoospermic patients were divided into Placebo, theophylline, zinc sulfate and theophylline+ zinc sulfate groups. At the beginning of the trial and three months after oral treatment, sperm parameters, viability and DNA fragmentation, oxidative stress and seminal plasma levels of inflammatory and pro-inflammatory markers and theophylline and zinc levels in the blood and seminal plasma were analyzed using the relative techniques and kits. Also, the conception rates following the trial were reported at the end of study. Data were analyzed using one-way ANOVA, Tukey’s test and paired t-test and the means were considered significantly different at P<0.05.
Results: Sperm parameters, oxidative stress, levels of inflammatory and pro-inflammatory markers ameliorated significantly in three groups compared to the placebo while these changes were more significant in the theophylline+ zinc sulfate group. Sperm DNA fragmentation occurred at a significantly lower rate in the zinc sulfate and theophylline+ zinc sulfate groups compared to the Theophylline group. The theophylline and zinc levels in the blood and seminal plasma increased in the theophylline and zinc sulfate groups, respectively. The overall conception rate was 38.3% in this study.
Conclusions: Co-administration of theophylline and zinc sulfate, not only improves sperm parameters and reduces oxidative stress and inflammation but also protects the sperm DNA from fragmentation caused by theophylline. Therefore, this combination is recommended in infertile men with asthenoteratozoospermia.

研究问题：茶碱可改善患者的精子质量，但同时会引发精子DNA碎片化。本研究旨在探讨硫酸锌与茶碱联合给药是否可降低弱畸精子症（asthenoteratozoospermia）患者的精子DNA碎片化程度。研究设计：将120例弱畸精子症患者分为安慰剂组、茶碱组、硫酸锌组以及茶碱联合硫酸锌组。于试验初始阶段及口服给药3个月后，采用相关技术与试剂盒检测精子参数、精子存活率与DNA碎片率、氧化应激水平、精浆中炎症及促炎标志物水平，以及血液与精浆中的茶碱和锌元素水平。同时于研究终点记录试验后的受孕率。数据采用单因素方差分析（one-way ANOVA）、Tukey检验与配对t检验进行分析，以P<0.05作为差异具有统计学意义的判定标准。研究结果：与安慰剂组相比，其余三组的精子参数、氧化应激水平及炎症与促炎标志物水平均得到显著改善，且茶碱联合硫酸锌组的改善效果更为显著。与茶碱组相比，硫酸锌组与茶碱联合硫酸锌组的精子DNA碎片率显著更低。茶碱组与硫酸锌组的血液及精浆中，茶碱与锌元素水平分别升高。本研究的总体受孕率为38.3%。研究结论：茶碱联合硫酸锌给药不仅可改善精子参数、减轻氧化应激与炎症反应，还可保护精子DNA免受茶碱诱导的碎片化损伤。因此，该联合给药方案推荐用于弱畸精子症不育患者。