Andressa Fernandes Ferrette’s scientific contributions

Introduction: Marijuana, the popular name for dried Cannabis sativa, is the most consumed drug worldwide. The main compound and most potent psychoactive agent, delta-9-tetrahydrocannabinol ( THC), acts as a negative competitor to the endogenous cannabinoid anandamide, by interacting with specific receptors CNR1 (GeneID 1268) and CNR2 (GeneID 1269). These receptors are expressed mostly in the central nervous system (CNR1) and sperm (CNR1 and CNR2) affecting sperm motility and acrosome reaction. Objective: To examine the effects of Marijuana consumption on seminal parameters and hormonal levels in men Methods: The study included 34marijuana users (study group) aged 21 to 58 years-old, and 814 pre-vasectomy patients (control group) from both the private laboratory Androscience and the Section of Andrology - HCFMUSP. Seminal analysis was performed according to the WHO’s guidelines and morphology also according to the Kruger´s criteria. Data analysis was performed using the Wilcoxon test and a linear model of gamma distribution to extract the age effects on each parameter; p value of <0.05 was adopted. Results: Significant effect of Marijuana was observed in LH levels, seminal pH, total sperm count, total progressive motility and both WHO and Kruger morphology (p<0.001) Conclusion: The consumption of C. sativa has a significant negative effect on male reproductive health, reflected in a significant elevation of LH levels and a significant reduction in sperm count, progressive motility and morphology. Although the negative impact of THC consumption on sperm presented here confirms previously reported data, there is no report on increased LH levels in Marijuana smokers, suggesting an impact of the drug on the hypothalamus-hypophysis-gonadal axis.

Introduction: The effect of finasteride 1mg/daily on spermatogenesis and its increased use by young males to treat and to prevent male baldness is of concern for the proportion and widespread of prescriptions by dermatologists unaware of its potential reproductive effects. Methods: We studied 19 male subjectrs who came for an initial andrological evaluation and compared results with a group of age-matched 174 pre-vasectomy candidates with no risk factors for sperm/testicular dysfunction. Each patient filled a complete medical report that includes Habits and Lifestyle patterns: use of drugs/mediation. Patients who self-reported use of finasteride 1mg for more than one year were included. Results: Finasteride users had significantly decreased: Total Sperm Count (p=0.005), Total Motile Sperm Count (p=0.011) and Total Motility (p=0.022) and increased immotile sperm (p=0.02). Total testosterone levels were decreased (p=0.03) and LH levels were increased (p=0.001). Creatine-kinase activity which is a marker of sperm immaturity was increased in finasteride users (p=0.009) Conclusions: Our results demonstrate that finasteride use in young patients may be contraindicated if they are willing to father their own offspring. We do not yet know the long-term effects on male reproductive health and recovery rate after discontinuation, but this study highlights new information on counseling patients by andrologists and points to a better evaluation of male reproductive and sexual health before prescribing finasteride.by dermatologists and other health professionals.