The Effect of Oral Phosphodiesterase-5 Inhibitors on Sperm Parameters: A Meta-analysis and Systematic Review

作者：Tan, Ping; Liu, Liangren; Wei, Shiyou; Tang, Zhuang; Yang, Lu; Wei, Qiang^*

来源：Urology, 2017, 105: 54-61.

DOI：10.1016/j.urology.2017.02.032

• REACTION IN-VITRO
• ERECTILE DYSFUNCTION
• INFERTILE MEN
• REPRODUCTIVE HORMONES
• SILDENAFIL CITRATE
• SEMEN PARAMETERS
• MOTILITY STIMULANT
• DANISH MEN
• TADALAFIL
• QUALITY

OBJECTIVE To perform a systematic review and meta-analysis to evaluate the effect of phosphodiesterase-5 (PDE5) inhibitors on sperm parameters. @@@ METHODS A systematic literature search was performed. Mean value and its standard deviation (mean +/- standard deviation) were used to perform quantitative analysis. Statistic heterogeneity scores were assessed with the standard Cochran Q test and I-2 statistic. All statistical analyses were conducted by RevMan 5.3. @@@ RESULTS Eleven studies embraced a total of 1317 participants and 19 subgroups or trials were included. Acute administration of PDE5 inhibitors had no effect on semen volume (mean value [MD] = 0.26; 95% confidence interval [CI]: 0.00-0.48) and sperm concentration (MD = 2.04; 95% CI: -2.95 to 7.04). However, the percentage of motile spermatozoa (MD = 7.05; 95% CI: 2.59-11.51), the percentage of total progressive motility(MD = 6.23; 95% CI: 2.43-10.04), and rapid progressive motility(MD = 3.11; 95% CI: 0.23-5.99) were increased after oral PDE5 inhibitors treatment. Interestingly, these significant changes were observed only in infertile men but not in normal patients (MD = 6.89, P < .001 vs MD = 0.67, P = .71; MD = 6.64, P = .001 vs MD = 2.11, P > .05; and MD = 3.89, P = .04 vs MD = 0.92, P = .59, respectively). The percentage of morphologically normal spermatozoa also increased in infertile men (MD = 12.15; 95% CI: 5.16-19.15). Limited evidence showed the linearity, abnormal forms of spermatozoa, as well as reproductive hormones (total testosterone, free testosterone, luteinizing hormone, and follicle-stimulating hormone) did not benefit from PDE5 inhibitors treatment. @@@ CONCLUSION Oral PDE5 inhibitors treatment could modestly increase the sperm motility and morphology in infertile men.

• 出版日期2017-7
• 单位四川大学