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Hum. Reprod. Advance Access originally published online on January 5, 2007
Human Reproduction 2007 22(4):1047-1051; doi:10.1093/humrep/del490
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© The Author 2007. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Sperm quality and pregnancy rate after COX-2 inhibitor therapy of infertile males with abacterial leukocytospermia

Laura Gambera1,4, Francesca Serafini1,4, Giuseppe Morgante1,4, Riccardo Focarelli2, Vincenzo De Leo1,4 and Paola Piomboni3,4,5

1 Department of Pediatrics, Obstetrics and Reproductive Medicine 2 Department of Evolutionary Biology 3 Department of Surgery, Biology Section, University of Siena, Center for the Diagnosis and Treatment of Couple Sterility, Siene, Italy 4 Center for the Diagnosis and Treatment of Couple Sterility, Azienda Ospedaliera Universitaria Senese, Policlinico Le Scotte, Viale Bracci, Siena, Italy

5 To whom correspondene should be addressed at: Department of Surgery, Biology Section, University of Siena, Center for the Diagnosis and Treatment of Couple Sterility, S. Maria alle Scotte Hospital, Viale Bracci, 53100 Siena, Italy. Tel: +39 0577 586632; Fax: +39 0577 586632; E-mail: piomboni{at}unisi.it

BACKGROUND: Leukocytes are a frequent finding in seminal plasma of infertile males with abacterial inflammation. We evaluated the effects of treatment with rofecoxib, a cyclooxygenase-2 inhibitor, on sperm quality and pregnancy rate after intrauterine insemination (IUI) or monitored intercourse.

METHODS: We selected 47 infertile patients referred to our sterility centre for semen analysis. Sperm evaluation was performed by light microscopy with Papanicolau and eosin staining, before and 1 month after therapy. Swim-up selection was carried out in two steps. Starting 6–8 weeks after the end of therapy, couples underwent different procedures of assisted fertilization according to their semen parameters.

RESULTS: Semen analysis 30 days after the end of therapy showed a significant reduction in leukocyte concentrations with respect to baseline, an improvement of sperm motility and morphology, particularly the presence and shape of the acrosomal complex and tail structure. After monitored intercourse and IUI, pregnancy rate was 15.8 and 11.3%, respectively.

CONCLUSIONS: Our results suggest that a decrease in leukocytospermia after rofecoxib therapy was associated with recovery of all seminal characteristics in basal and swim-up selected samples. This general improvement could justify the positive outcome of ART after anti-inflammatory therapy.

Key words: COX-2 inhibitor/infertility/leukocytospermia/pregnancy rate/sperm quality

Submitted on August 22, 2006; resubmitted on November 14, 2006; accepted on November 29, 2006.


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