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Tikrit Journal of Pure Science Vol. 24 (5) 2019
1
Tikrit Journal of Pure Science
ISSN: 1813 – 1662 (Print) --- E-ISSN: 2415 – 1726 (Online)
Journal Homepage: http://tjps.tu.edu.iq/index.php/j
The effect of L-Arginine of treatment for infertile men on semen
parameters
Abdul Rahman Jihad Manssor1, Zaid Mohammed Mubarak Al–Mahdawi1, Azzawi Mustafa Hadi2
1 Department of biology , College of Science , University of Tikrit , Tikrit , Iraq
2 Department urology, College of Medicine , University of Tikrit , Tikrit , Iraq
https://doi.org/10.25130/tjps.v24i5.408
A r t i c l e i n f o.
Article history:
-Received: 24 / 12 / 2018
-Accepted: 14 / 4 / 2019
-Available online: / / 2019
Keywords: Male infertility, L-
Arginine, semen parameters.
Corresponding Author:
Name: Abdul Rahman Jihad
E-mail: ajmansoor@tu.edu.iq
Tel:
ABSTRACT
The aim of the study is to determine the effect of oral supplement of L-
Arginine on semen parameters as a treatment for infertile men. Patients
and methods: The study conducted on 15 infertile men at infertility clinic
in SalahadDin general hospital and private clinics and laboratories in
Tikrit city from beginning of March to the end of July 2018. Infertility is
a common clinical problem affecting 13-15% of couples worldwide. The
prevalence varies throughout developed and undeveloped countries,
being higher in the latter in which limited resources for diagnosis and
treatment exist. L-arginine was given daily and orally at a dose 1000 mg
one capsule per day morning after breakfast.
Results: There was a significant increase in total sperm count after
treatment with L- Arginine as compare with that before treatment. Also
there was significant elevation active motility and Ejaculate volume after
treatment with L- Arginine, as compare with that before treatment.
However, there are significant reductions in Sluggish motility, abnormal
sperm shape and non-motile sperms after treatment with L-Arginine as
compare with that before treatment.
Introduction
Male infertility cases may be divided into four major
types; male factors, female factors, combined factors
and unexplained infertility, [1, 3]. Also, male
infertility classify either as a primary infertility if no
pregnancy has ever occurred or secondary type of
infertility, if it occurred after one or more pregnancy
approximately 15% of couples attempting their first
conception meet with a failure, and 10% infertility,
[4, 5, 6].Magnesium, iron and cobalt are adverse
factors in human infertility,[7]. Over the past 20
years, data available reveal that in approximately
30% - 50% of the infertility cases, the cause is found
in the man alone and another 20% the causes are
found in both, while in 50% - 70% the causes are
found in female alone, [8]. Recently more concerns of
environmental and occupational exposure, [9].
Physiology and metabolism. It is not considered
essential because humans can synthesize it de novo
from glutamine, glutamate, and proline. However,
dietary intake remains the primary determinant of
plasma arginine levels, since the rate of arginine
biosynthesis does not increase to compensate for
depletion or inadequate supply [10].Arginine contains
four nitrogen atoms per molecule, making it the most
abundant nitrogen carrier in humans and animals
(Figure 1). Although it is not a major inter-organ
shuttle of nitrogen, arginine nevertheless plays an
important role in nitrogen metabolism as an
intermediate in the urea cycle, making it essential for
ammonia detoxification [11]. The aim of this study is
see the effect of oral L- Arginine supplement on
sperm parameters in infertile men in Salah al-deen
governorate.
Patients and Methods
A follow up follow up study was done on 15 infertile
men and 30 normal fertile married as control.
Samples were obtained from infertility clinic in
SalahadDin General Hospital, and private clinics
from beginning of March to the end of July
2018.After sexual abstinence for at least three days,
semen samples were collected from patients and
control subjects. Semen samples containers were
labeled (name, age, time of ejaculates and duration of
abstinence).
Tikrit Journal of Pure Science Vol. 24 (5) 2019
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The semen samples were allowed to liquefy in an
incubator at 37Co for 30 minutes, and within half to
one hour, semen parameters were analyzed, [13,14].
All semen parameters were measured according
standard procedures, such as semen volume, sperm
count, motility, pH, Vitality and normal morphology
and abnormal shape, [15].The, blood samples were
obtained from male infertile patients and normal
fertile healthy as a control. Biochemical tests like
GSH; MDA, IL-6, and CRP, were analyzed according
standard procedures, [16, 17].Treatment of infertile
patients was done by giving with L-Arginine at doze
quall to 1000 mg by one capsule per daily for four
months.
Result and Discussion
In the present study, table (1) shows that there is
highly significant increase in total sperm count after
treatment with L- Arginine (55 ± 7.1 million/ml), as
compared with that before treatment (27± 2.28). Also,
there is significant increase in active motility of
sperm after treatment with L- Arginine (35± 5.89
million/ml) as compared with that before treatment
(15 ±4.45), (p≤ 0.05). Moreover, there is also, a
significant increase in Ejaculate volume after
treatment with L-Arginine (3.15 ±0.84ml) as
compared with that before treatment (2.2 ± 0.52),
(p≤0.05) [18].
Table (1) : The mean & standard deviation of semen parameters of infertile men before & after treatment
with L- Arginine.
However, there is significant reduction in Sluggish,
abnormal sperm shape and non-motile sperm count
after treatment with L-Arginine, as compared with
that before treatment (p≤ 0.05). In the present study
there was a low sperm count in infertile men
compared with control group.These results agreed
with previous result which found that a reduction in
sperm count, sperm motility& morphology of sperm
in semen of infertile men than healthy control
subjects, [14].Also the present study agrees with
previous study done in Tikrit on infertile men, [15].
and in Mosul city which stated that a reduction in
semen quality, [16, 17 ,18].Table (2) show In the
present study, there is significant elevation in the
concentration of GSH in the serum of infertile men
after treatment with L-Arginine as compared with the
value of GSH before treatment, (P≤ 0.05). Also, there
are significant reductions in the concentration of
MDA, IL-6, and C- Reactive protein (CRP). In the
serum of infertile patients after treatment with L-
Arginine as compared with values before treatment,
(table 2).
Table (2): The mean & standard deviation of serum (GSH, MDA, IL-6, CRP) of infertile men before &
after treatment with L- Arginine.
P value
After treatment
Before treatment
Parameters
0.01
0.524±2.018
0.369±0.8980
GSH (µmol/l)
0.01
0.412±0.8020
0.4890 1.4700±
MDA(µmol/l)
0.05
1.231± 6.100
2.073 ± 9.432
IL-6 (pg/ml)
0.05
0.368 ± 0.113
0.7200 ± 0.238
C.R.P (mg/l)
L-arginine which provides protection against
oxidative stress which is likely to act as an
antioxidant, [19,20]. L-arginine may protects
spermatozoa against lipid peroxidation by increased
the release of nitric oxide gas, (NO production), [21,
22, 23].Supplement of 500 mg arginine per day to
infertile men for 8-12 weeks markedly increased
sperm count and motility in a majority of patients,
and resulted in reduction of MDA level, and
increased testosterone hormone concentration, [24,
25].Sperm cells from infertile men with oligospermia
have a significantly higher activity of arginase
enzyme than fertile men. The study found a positive
relationship between motility of sperm and the
activity of the enzyme,[26,27].
P value
After
Before
Semen parameters
0.01
55 ± 7.1
27 ± 2.88
Total count (mil/ml)
0.05
35±5.89
15±4.454
Active %
0.05
17±2.88
37±6.454
Sluggish Motility %
0.01
15±4.67
40±7.072
Non Motile %
0.05
60±4.08
30±4.782
Normal Sperms %
0.05
25 ±3.23
50±6.342
Abnormal Sperms %
ns
6.9±6.8
7.3 ± 1.02
PH
0.01
75.5±6.4
33.77 ±14.3
Viability %
0.05
3.15 ± 0.84
2.2±0.52
Ejaculate Volume ml
Tikrit Journal of Pure Science Vol. 24 (5) 2019
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Tikrit Journal of Pure Science Vol. 24 (5) 2019
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