ARTICULO ORIGINAL
Chronic administration of nonsteroidal-antiinflammatory
drugs (nsaids): effects upon mouse reproductive functions.
Martini, Ana Carolina¹;
Vicentini Laura; Santillán María E; Stutz Graciela;
Kaplan Raquel; Ruiz Rubén D¹.;
Fiol de Cuneo Marta¹
Revista Facultad Ciencias Medicas 2008; 65(2):
41-51
Instituto de Fisiología,
Facultad de Ciencias Médicas, Universidad Nacional de
Córdoba. Santa Rosa 1085, X5000ESU - Córdoba, Argentina.
1.- Established investigator
from the Consejo Nacional de Investigaciones Científicas y
Tecnológicas (CONICET), Argentina
Introduction:
Prostaglandins (PGs) have been involved as regulators of
several physiological processes related to reproduction (2,
38). Nonsteroidal-antiinflamatory drugs (NSAIDs), substances
that interfere with the biosynthesis and/or metabolism of
such eicosanoids, may affect male and/or female reproductive
processes (5, 8, 15, 17, 32, 39). However, although NSAIDs
are widely employed for the treatment of subacute and/or
chronic diseases such as muscular pain, headache, lupus
erythematosus, rheumatoid arthritis, etc, there is no
conclusive knowledge about the possible adverse effects of
these agents on reproductive functions. Since some of the
mentioned diseases affect men and/or women in their fertile
years, more detailed studies about this topic are necessary.
Besides, the majority of the publications on this subject
have been performed employing high doses and/or acute
administration of these drugs (7, 16, 25, 28), the effects
of long-term administration of low or moderate doses of
NSAIDs on gamete characteristics and fertility remain to be
established.
It was not until 1996, that the first case reports appeared
describing transient infertility due to the inhibition of
ovulation following treatment with indomethacin, diclofenac,
piroxicam and naproxen in female patients with autoimmune
diseases and chronic NSAIDs administration (26, 32).
Recently, we published a paper about the effects of long
term administration of aspirin-like drugs upon seminal
parameters in humans; we found detrimental effects;
reduction in seminal volume, total number of spermatozoa,
percentages of motile, viable and morphologically normal
cells and diminished seminal fructose levels (21).
Nevertheless, it was a retrospective study with all the
ethical and methodological limits for human research.
The purposes of this study were to evaluate in adult mice,
possible effects of chronic administration of low or
moderate doses of ibuprofen or piroxicam upon some
parameters that reflect reproductive physiology: in females,
ovulation index, oocyte maturity and spermatozoa migration
through the genital tract after mating and in males, sperm
concentration and motility, sperm membrane maturation,
viability, response to hypoosmotic swelling test and
spontaneous acrosome reaction. In both genders we also
evaluated the in vitro and in vivo fertilization indices,
plasma levels of reproductive hormones and cyclooxigenase
inhibition in reproductive tissues.
Material and Methods
Animals
Inbreed sexually mature (70 days) Albino Swiss mice SWR/J(q)
were employed. They were maintained on 12:12 h light:dark
basis, and at 20 4C, with mouse pelleted food (Gepsa
Feeds, Argentina) and water ad libitum. They were housed in
groups not bigger than five animals (all from the same
experimental group) in cages of 22x30x9 cm, with wood
shavings as bedding material.
Drugs administration
Ibuprofen or piroxicam (Sigma Chemical Co.) were
administered in three doses: Ibuprofen A, B or C (0.56, 1.12
or 1.68 mg/100g/day respectively) or Piroxicam A, B or C
(0.028, 0.056 or 0.084 mg/100g/day respectively); they were
calculated on the basis of commonly human injectable doses.
Ibuprofen was dissolved in propylene glycol (3.4 M) and
vehiculized in 0.9% NaCl solution. Piroxicam was dissolved
in dimethylsulfoxide (3.5 M) and vehiculized in 0.9% NaCl
solution.
Females were injected daily (i.p.) for 35 days (period that
covers at least 7 oestrus cycles) with the doses A or C of
ibuprofen or piroxicam. Males were injected daily (i.p.) for
60 days (period that covers at least one complete mouse
spermatogenic cycle and the epididymal migration) with the
doses B or C of ibuprofen or piroxicam. The effects of the
doses A of these compounds upon male reproductive function
were previously published (34). Control animals were
injected only with the solvent and vehicle and for the same
period.
An overview of the treatments, parameters and number of
animals evaluated is summarized in
Table 1.
Gametes
Modified Tyrode´s medium (11) supplemented with 4 mg/ml of
fraction V BSA (Sigma Chemical Co.) was employed and gametes
were maintained till use in an incubator at 37C (5% CO2:95%
air) and 100% humidity.
Oocytes were harvested from natural cycling or from
superovulated females: 5 IU PMS (i.p.; Sigma Chemical Co.)
followed 48 h later by 10 IU hCG (i.p.; Endocorion, ELEA).
The animals were sacrificed (approximately at 9 a.m.) by
cervical dislocation or decapitation (in order to obtain
plasma for hormone assays) at oestrus morning (detected by
male receptivity) or 16-18 h after the hCG injection, and
the cumulus-oocyte complexes were collected from the
oviducts by puncturing the swollen ampulla and were
allocated into center-well dishes with 1 ml Tyrode´s
solution.
After male sacrifice (approximately at 9 a.m. by
decapitation or cervical dislocation), spermatozoa were
obtained by making incisions in the isolated caudal portion
of the epididymis and allowing the sperm to extrude into 2
ml of the medium.
Reproductive parameters
- Ovulation index: was evaluated in natural cycling (at
oestrus morning) or in superovulated females; results are
expressed as number of oocytes collected from the ampullas/female.
- Oocyte maturity: after removal of the cumulus oophorus
with hyaluronidase this parameter was determined evaluating,
in an inverted microscope at 400x, the percentage of oocytes
without a visible germinal vesicle.
- Spermatozoa migration through the female genital tract: as
previously described (10) around 8:00 a.m. untreated males
and treated females were housed together and observed; 110
min after, all mated females were sacrificed and the uterus
was flushed into a dish containing 2 ml medium and incubated
for 10 min. The oviducts were located into another dish with
1 ml Tyrode, cut into small pieces and taken to the
incubator for 10 min. After this period, sperm functional
activity was evaluated (sperm concentration, motility,
viability and acrosomal status).
- Sperm concentration and motility: were measured in a
Makler counting chamber (Sefi-Medical Instruments, Israel)
under an inverted microscope (Olympus CK2, Japan) at x 200
magnification (19). As previously described, the results
were expressed as percentage of motile cells (progressive
plus non-progressive spermatozoa). No fewer than 100 gametes
were examined (10). In order to evaluate the sperm membrane
immaturity, percentages of bending spermatozoa and those
with cytoplasmic drop were also determined.
- Sperm viability: was evaluated by supravital staining with
Hoechst 33258 (H258) (3 mg/ml in isotonic solution) (Calbiochem,
USA) (37). Using the appropriate ultraviolet fluorescence
optics (Axiolab, Zeiss, Germany), spermatozoa showing bright
fluorescent nuclei were scored as dead and cells which
excluded the H258 were scored as viable. The viability of at
least 100 cells was assessed and results were expressed as
percentage of viable spermatozoa.
- Hypoosmotic swelling test (HOST): as previously described
(27), 0.1 ml of sperm suspension was mixed with 1 ml of the
hypoosmotic solution (100 mOsm/l) for 45 min (37C).
Evaluations were made by phase-contrast microscopy at a
magnification of x 400; one hundred or more cells were
observed; results are expressed as the percentage of
spermatozoa that showed tail swelling.
- Acrosomal integrity: as previously described, it was
determined by staining with Pisum sativum agglutinin
labelled with fluorescein isothiocyanate (FITC-PSA) (Sigma
Chemical Co., USA) (10). The H258 was dissolved in isotonic
solution and added to a final concentration of 1.5 g/ml and
then co-incubated with spermatozoa for 10 min. Samples were
washed free of unbound stain by centrifugation twice at 400
g for 10 min with 2 ml of isotonic solution; the supernatant
was then carefully removed, cells were mounted as smears on
glass slides, dried in an incubator and fixed with methanol
for 30 sec. The slides were washed with a stream of
distilled water for 2 min and after drying, spermatozoa were
incubated with 30 g/ml FITC-PSA in isotonic solution for 30
min and washed again with a stream of distilled water for 2
min. Finally, in order to avoid fading of fluorescence, the
slides were mounted in mounting medium containing 1 mg/ml
sodium azide and 100 mg/ml 1,4-diazabicyclo (2.2.2) octane (DABCO)
in 90% (v/v) glycerol and 10% (v/v) DPBS (pH 9). Acrosomal
status and viability were evaluated under an epifluorescence
microscope (x 1000). The staining patterns were described as
intact or reacted acrosome. At least 100 viable cells were
assessed. For the experiments of “spermatozoa migration
along the female genital tract after mating”, both viable
and dead spermatozoa were considered.
- In vitro fertilization rate: this procedure was performed
according with Yelian and Dukelow (1992). After
superovulation induction, the treated females were
sacrificed and the oocytes were recovered as described above
from the swollen ampulla and placed in 1 ml of Tyrode´s
medium and inseminated with ~1 x 106/ml epididymal
spermatozoa pooled from untreated males.
For the males evaluation, the oocytes of untreated females
were pooled, located (n20) in a separate center-well dish
and inseminated with ~1 x 106/ml epididymal spermatozoa of
each treated male.
The culture dishes were kept at incubator for 22 h. After
this time, assessment of results was performed employing an
inverted microscope and embryos in the pronucleus stage or
with two or more blastomeres were considered as fertilized.
- In vivo fertilization rate and litter size: males and
females were housed together for 4 days (only one oestrus
cycle). After twelve days, females were sacrificed and the
number of fetuses in the uterus was counted. Each treated
male were housed with 2-3 untreated females and each treated
female were housed with 2 untreated males.
- Plasma FSH and testosterone levels: blood samples were
collected immediately after decapitation (at the morning of
oestrus in the females), centrifuged for 30 min at 400 g,
and plasma was stored at -20C until assayed. FSH plasma
levels were assayed with a rat IRMA kit (Biocode) with a
sensibility of 0.2 ng/ml. For testosterone determination a
mouse RIA kit (Immunotech) with 0.1 ng/ml of sensibility was
employed. The final determinations were performed in an
automatic gamma counter (ANSR – Abbott).
- Cyclooxigenase inhibition: as previously described (3),
the ability of reproductive tissues to radio-convert C14
arachidonic acid into PGs was determined employing a liquid
chromatography technique. Uterus and seminal vesicles were
obtained 20 h after the last drug injection, in order to
investigate the possible chronic cyclooxigenase inhibition
exerted by the NSAIDs chronic treatment upon reproductive
tissues. The PGs used as controls were 6-keto-PGF1, PGF2,
PGE2 and TXB2 (Sigma Chemical Co.). The quantifications were
performed in a beta-counter (Beckman LS 7000) and the
results were expressed as proportion of labelled arachidonic
acid converted into PGs.
Statistical analysis
Results were processes with the software program Infostat (Infostat
1.1, version 2000, grupo Infostat, National University of
Cordoba, Argentine). Values are expressed as MeanSEM or
percentage. As adequate, Student’s “t”- test, ANOVA or Chi-square
test were applied. When necessary, percentages were
converted to a Gaussian distribution by arcsin
transformation. All p values 0.05 were considered
statistically significant.
Results:
Effects of NSAIDs upon female reproductive function
The administration of the dose A of ibuprofen for 35 days to
adult female mice induced a significant reduction in
spontaneous as well as in induced ovulation index (p< 0.05)
(Figure 1). Nevertheless, the higher doses of ibuprofen here
employed (dose C) did not significantly modify this
parameter. Piroxicam, doses A or C, did not affect this
variable either (Induced ovulation -oocytes/female-: control
19.7 1.5, n=21, piroxicam dose A 17.9 2.4, n=22; control
21.6 4.1, n=10, piroxicam dose C 16.4 4.3, n=10.
Spontaneous ovulation -oocytes/female-: control 10.0 0.6,
n= 10, piroxicam dose A 9.6 0.7, n=9).
In order to evaluate if an “acute administration” of
ibuprofen (dose C) exerts a comparable effect upon ovulation
rates vs chronic ones (35 days), females were injected for
only two days (those of PMS and hCG administration) with
this drug. Ovulation indices obtained after acute treatment
did not differ from their respective controls, but were
significantly higher than those obtained after chronic
administration (36.1 4.3, n=8; 22.8 3.2, n=18
respectively; p< 0.05).
Oocyte maturity was not modified by NSAIDs administration (ibuprofen
or piroxicam) in any of the doses here assayed (results not
shown). In vitro or in vivo fertilization indices remained
unaltered also (Table 2).
On oestrus day, no changes were detected in plasma FSH
levels (females treated for 35 days: control 17.7 1.8 ng/ml,
n=13; ibuprofen dose A 21.8 3.2 ng/ml, n=8; control 23.7
2.4 ng/ml, n=10; ibuprofen dose C 22.4 3.4 ng/ml, n=11).
When sperm migration along the female genital tract was
evaluated, we found that piroxicam administration (dose A)
elicited a significant decrease in the concentration of
spermatozoa found in the uterus (control: 6.9 1.5 x106/ml,
n=8; piroxicam: 3.6 1.2 x 106/ml, n=9; p< 0.05). Ibuprofen
(dose A) did not significantly modify this parameter.
However, it must be remarked, that in all groups (control or
NSAIDs treated animals) we detected a physiological
reduction in oviductal sperm concentration vs uterine one
(p< 0.05). When comparing sperm functional activity of
samples obtained from the oviduct with those obtained from
the uterus, we detected in the last ones, a reduction in
motility and in viability and an increase in the percentage
of acrosome reacted cells. These effects were obtained in
control as well as in NSAIDs treated animals (Table 3).
We did not detect any effect of NSAIDs upon the conversion
of labelled arachidonic acid to PGs in the uterus from
females treated with ibuprofen dose C (Table 4) or with
piroxicam (results not shown).
Effects of NSAIDs upon male reproductive function
As can be seen in Table 5, the treatment of adult male mice
for 60 days with the dose B of ibuprofen or piroxicam did
not exert any effect in the functional activity of
epididymal spermatozoa. Similar results were obtained with
the highest dose of ibuprofen or piroxicam (results not
shown).
In vitro fertilization index of spermatozoa obtained from
males treated with ibuprofen (dose B) was significantly
lower than that of control ones (Table 6). No significant
changes in this parameter were evoked by dose C of ibuprofen
or piroxicam. Neither the proportion of pregnant females
mated with treated males nor the litter size were
significantly modified by any of the NSAIDs treatments here
assayed.
Plasma concentration of FSH and testosterone were 46.6 3.9
ng/ml (n=10) and 5.8 1.3 ng/ml (n=24) respectively in
control animals and they were not modified by ibuprofen (doses
C or B) or piroxicam (dose C) treatment.
No alterations in the proportion of labelled arachidonic
acid converted into PGs were detected in the seminal
vesicles of animals treated with the highest doses of
ibuprofen (Table 4) or piroxicam (results not shown).
Discussion:
In the present paper we evaluated the effects of chronic
administration of low or moderate doses of ibuprofen or
piroxicam upon adult mice reproductive function; both NSAIDs
frequently used in human therapy. Although these drugs have
been employed for decades, we did not find studies
evaluating the effects of low doses applied in long term
protocols upon reproductive function.
Effects of NSAIDs upon female reproductive function
The participation of PGs in mammalian ovulatory process is
well documented (38). On this basis, the significant
decrease in the ovulation rate elicited by ibuprofen (dose
A), can be attributed to eicosanoid synthesis inhibition.
However, we can not discard some effects on the phenomena
previously occurring, i.e. during oogenesis.
Piroxicam did not exert any significant effect on ovulation.
In this context, it must be considered that the potency of a
NSAID for inhibiting ovulation is correlated with their anti-inflammatory
ability (7, 8, 25); consequently could not be the same for
ibuprofen or piroxicam. On the other hand, the highest dose
of ibuprofen did not significantly alter ovulation indices.
It has been reported that some NSAIDs do not exert a dose-dependent
action on ovulation (39) and that, in prolonged NSAIDs
treatment, the eicosanoid synthesis reduction is not the
same for the different PGs series and also, that the
recuperation in the synthesis is uneven (18).
Moreover, PG effects are related with the individual
concentration of each PG as well as with their relative
concentration (18). These aspects explain results here
obtained with the both doses of ibuprofen here assayed.
Therefore, it can not be discarded that the higher doses of
NSAIDs could provoke compensatory mechanisms not evoked by
the smaller ones, which could include up-regulation of
receptors, increase in the cyclooxigenase synthesis (24),
decrease in the concentration and/or activity of PGs
catabolic enzymes (24, 25) and/or increase in the synthesis
of leucotrienes, substances also involved in the ovulatory
process (38, 39).
When ibuprofen was daily injected for 35 days there were no
chronic inhibition of cyclooxigenase activity in
reproductive tissues. In order to evaluate if an acute
administration of the same agent exerted a comparable effect
on ovulation, two single doses of ibuprofen were injected
simultaneously with the PMS and hCG. In chronic treated
animals a significant lower ovulation index than in acute
treated ones was detected. This finding suggests that
chronic administration of ibuprofen exerts more severe
alterations and/or some other effects beyond the
cyclooxigenase inhibition.
Although it is known that the cumulus-oocytes complexes
synthesize PGs that participate in the fertilization process
(6, 12), in our study we did not find any effect of NSAIDs
upon in vitro fertilization indices, which reached similar
values to those previously obtained in our laboratory (10,
20).
In vivo fertilization rates or the litter size remained
unchanged in treated females. Since ibuprofen (dose A)
diminished the ovulatory index, these results seem to be
contradictory. Nevertheless, these findings are explained by
the fact that in our experimental design, in order to avoid
implantation inhibition and/or abortions previously reported
(29, 33), drugs injection were interrupted the day before
male and female joining.
When we evaluated the effects of female piroxicam
administration (dose A) upon sperm migration through the
genital tract, we found a reduction in the concentration of
uterine spermatozoa. An involvement of PGs in sperm
migration was previously suggested by several authors (5,
38). When functional activity of spermatozoa obtained from
the oviduct was compared with those of gametes collected
from the uterus, results obtained were similar to those
reported in previous papers (10, 35). Briefly, the reduction
of sperm concentration, motility and viability and the
increase in the percentage of acrosome reacted sperm, are
explained by the occurrence of physiological processes such
as sperm capacitation or acrosome reaction induced by female
micro-environmental signals and not by the NSAIDs injected.
Finally, NSAIDs treatment did not modify the plasma levels
of FSH; this finding is in accordance with those of
Matsumoto et al (2001) and Sato et al (1974).
Effects of NSAIDs upon male reproductive function
When analyzing our results, it must be taken into account
that the spermatozoa have been obtained from the caudal
portion of the epididymis, and consequently they have not
been in contact with the seminal PGs. Nevertheless, PGs are
also synthesized in another portions of the reproductive
tract (including testis and epididymis) (4, 9). Moreover, it
is known that epididymal, as well as ejaculated spermatozoa,
synthesize PGs (14, 30). It is also relevant that in
contrast with the bibliography, in our experimental model,
NSAIDs were injected for 60 days, period that covers
spermatogenesis and epididymal transit.
Functional activity of epididymal spermatozoa was not
modified by NSAIDs treatments. In a previous paper employing
the dose A of ibuprofen or piroxicam, we obtained similar
results (34). Despite the species-specific differences that
must be considered, in humans, we found that the chronic
administration of low or moderate doses of NSAIDs (mainly
aspirin) exerted detrimental effects. Seminal volume, total
number of spermatozoa, motility, viability, percentage of
morphologically normal cells and seminal fructose levels
diminished significantly (21). These discrepancies can be
explained by functional membrane changes evoked by seminal
plasma components on ejaculated spermatozoa (36).
The detrimental effect upon the in vitro fertilization index
when ibuprofen (dose B) was administered, is in accordance
with previous studies by Aitken and Kelly (1985), who
reported that the PGs synthesized by the spermatozoa,
particularly from the E family, are involved in the
fertilization process. The increase induced by PGs on the
fertilization rate has been related to the ability of these
eicosanoids to enhance sperm Ca++ inflow (31). Furthermore,
the addition of three NSAIDs in a mouse in vitro
fertilization assay decreased the fertilization index (13,
15). Since our results were evoked only by the smaller dose
of ibuprofen and not by the higher one, the possible
compensatory mechanisms above suggested (for ovulation
response) would be operating.
Although it is well known that seminal PGs are involved in
the migration of the spermatozoa through the female genital
tract (2), we did not find any effect of male chronic NSAIDs
treatment upon the percentage of pregnant females or in the
litter size. The low pregnancy rates found in all the groups
studied here (control or treated males) can be explained by
the stressful stimulus of the daily puncture and/or
injection. In other experiments we detected alterations in
the erection and/or ejaculation processes without affecting
the sperm quality or the plasmatic levels of FSH or
testosterone (results not shown).
In conclusion, our data suggest that chronic administration
of low or moderate doses of NSAIDs exerts several
detrimental effects upon male and female reproductive
physiology, which depends, among other factors, from the
dose and/or the drug employed. Although possible species-specific
effects would be operating, when NSAIDs are administered to
patients in their fertile years, these results must be taken
into account.
ACKNOWLEDGEMENTS: This work was supported by grants from the
Agencia Córdoba Ciencia (ACC-S.E.) and the Secretaría de
Ciencia y Tecnología (SECyT), Universidad Nacional de
Córdoba.
References:
1. Aitken RJ, Kelly RW: Analysis of the direct effects of
prostaglandins on human sperm function. J Reprod Fertil;
1985, 73: 139-146.
[Full Text]
2. Bygdeman M, Gottlieb C, Svanborg K, Swahn ML: Role of
prostaglandins in human reproduction: recent advances. Adv
Prostag Thromb Leukot Res; 1987, 17: 1112-1116.
[Abstract]
3. Casalino SM, Linares JA, Goldraij A: Influence of
underfeeding on the spontaneous contraction and on
metabolism of labelled arachidonic acid in uteri isolated
from intact and ovariectomized rats. Prostaglandins Leukot
Essent Fatty Acids; 1996, 55: 155-158.
[Abstract]
4. Clavert A, Cranz C, Bollack C: Functions of the seminal
vesicle. Andrologia; 1990, 22: 185-192.
[Abstract]
5. Dawood My: Nonsteroidal antiinflammatory drugs and
reproduction. Am J Obstet Gynecol; 1993, 169: 1255-1265.
[Abstract]
6. Duffy DM, Stouffer RL: The ovulatory gonadotrophin surge
stimulates cyclooxygenase expression and prostaglandin
production by the monkey follicle. Mol Hum Reprod; 2001, 7:
731-739.
[Full Text]
7. Espey LL, Kohda H, Mori T, Okamura H: Rat ovarian
prostaglandin levels and ovulation as indicators of the
strengh of non-steroidal anti-inflammatory drugs.
Prostaglandins; 1988, 36: 875-879.
[Abstract]
8. Espey LL, Stein VI, Dumitrescu J: Survey of
antiinflammatory agents and related drugs as inhibitors of
ovulation in the rabbit. Fertil Steril; 1982, 38: 238-247.
[Abstract]
9. Farr CH, Ellis LW: In vitro contractility of rat
seminiferous tubules in response to prostaglandin, cyclic
GMP, testosterone and 2,4-dibromoacetophenone. J Reprod
Fertil; 1980, 58: 37-42.
[Full Text]
10. Fiol De Cuneo, M, Ruiz RD, Ponce AA, Maldonado X,
Lacuara JL: Time-related changes in functional activity of
mouse spermatozoa during in vitro or in vivo incubation. J Exp Anim Sci; 1994, 36: 189-200.
[Abstract]
11. Fraser LR: Calciun channels play a pivotal role in the
sequence of ionic change involved in initiation of mouse
sperm acrosomal exocytosis. Mol Reprod Dev; 1993, 36: 368-
376.
[Abstract]
12. Gurevich M, Harel-Markowitz E, Marcus S, Shore LS,
Shemesh M: Prostaglandin production by the oocyte cumulus
complex around the time of fertilization and the effect of
prostaglandin E on the development of the early embryo. Reprod Fertil Dev; 1993, 5: 281-283.
[Abstract]
13. Hayashi S, Noda Y, Mori T: Analysis of the role of
prostaglandins in the fertilization process. Eur J Obstet
Gynecol Reprod Biol; 1988, 29: 287-297.
[Abstract]
14. Herrero MB, Franchi AM, Gimeno MAF: Mouse spermatozoa
can synthesize PGE2 and 5-HETE in vitro: stimulatory action
of nitric oxide. Prostaglandins Leukot Essent Fatty Acids;
1995, 53: 347-350.
[Abstract]
15. Joyce CL, Nuzzo NA, Wilson L, Zaneveld LJD: Evidence for
a role of cyclooxigenase (prostaglandin synthetase) and
prostaglandins in sperm acrosome reaction and fertilization.
J Androl; 1987, 8: 74-82.
[Full Text]
16. Katz E, Dharmarajan AM, Sueoka K, Ghodganonkar RB, Dubin
NH, Wallach EE: Effects of systemic administration of
indomethacin on ovulation, luteinization, and
steroidogenesis in the rabbit ovary. Am J Obstet Gynecol;
1989, 161: 1361-1366.[Abstract]
17. Knuth UA, Kühne J, Crosby J, Bals-Pratsch M, Kelly RW,
Nieschlag E: Indomethacin and oxaprozin lower seminal
prostaglandin levels but do not influence sperm motion
characteristics and serum hormones of young healthy men in
placebo-controlled double-blind trial. J Androl; 1989, 10:
108-119.
[Full text]
18. Löscher W, Lüttgenau H, Schlegel W, Krüger S: Pharmacokinetics of non-steroidal anti-inflammatory drugs in
male rabbits after acute and chronic administration and
effect of chronic treatment on seminal prostaglandins, sperm
quality and fertility. J Reprod Fert; 1988, 82: 353-364.
[Full Text]
19. Makler A: The improved ten-micrometer chamber for rapid
sperm count and motility evaluation. Fertil Steril; 1980,
33: 337-338.
[Abstract]
20. Martini AC, Fiol De Cuneo M, Ruiz RD, Ponce AA, Lacuara
JL: In vitro parthenogenesis of mouse oocytes under several
experimental conditions. Zygote; 2000, 8: 45-49.
[Abstract]
21. Martini AC, Molina RI, Tissera AD, Ruiz RD, Fiol De
Cuneo M: Analysis of semen from patients chronically treated
with low or moderate doses of aspirin-like drugs. Fertil
Steril; 2003, 80: 221-222.
[Abstract]
22. Matsumoto H, MA W, Smalley W, Trzaskos J, Breyer RM, Dey
SK: Diversification of cyclooxygenase-2-derived
prostaglandins in ovulation and implantation. Biol Reprod;
2001, 64: 1557-1565.
[Full Text]
23. Mayes PA: Metabolismo de los ácidos grasos insaturados y
de eicosanoides. In: Murria RK, Granner DK, Mayes PA Rodwell
VW. Bioquímica de Harper, El Manual Moderno, México. 1994,
p269-278.
24. Nayak NR, Sengupta J, Ghosh D: Antinidatory effects of
luteal phase administration of mifepristone (RU486) in
associated with changes in endometrial prostaglandins during
the implantation window. Contraception; 1998, 58: 111-117.
[Abstract]
25. Orczyk GP, Behrman HR: Ovulation blockade by aspirin or
indomethacin. In vivo evidence for a role of prostaglandin
in gonadotropin secretion. Prostaglandins; 1972, 1: 3-20.
[Abstract]
26. Ostensen P, Villiger PM:
Nonsteroidal anti-inflammatory
drugs in systemic lupus erythematosus. Lupus; 2001, 10:
135-139.
[Abstract]
27. Ruiz RD, Fiol De Cuneo M, Santillán ME, Ponce AA,
Vincenti L, Lacuara JL, Stutz G: Hypoosmotic sweelling test
(HOST) for assessing the integrity of the mouse sperm
membrane and its relationship with other functional
parameters. Effects of 2-deoxyadenosine. J Exp Anim Sci;
1995 37: 156-164.
28. Sato T, Taya K, Jyujo T, Igarashi M: Ovulation block by
indomethacin, an inhibitor of prostaglandin synthesis: a
study of its site of action in rats. J Reprod Fert; 1974,
39: 33-40.
[Full Text]
29. Scherle PA, Ma W, Lim H, Dey SK, Trzaskos JM: Regulation
of cyclooxygenase-2 induction in the mouse uterus during
decidualization. An event of early pregnancy. J Biol Chem;
2000, 275: 37086-37092.
[Full text]
30. Shalev J, Shemesh M, Levinshal T, Marcus S, Breitbart H: Localization of cyclooxigenase and production of
prostaglandins in bovine spermatozoa. J Reprod Fertil; 1994,
101: 405-413.
[Full Text]
31. Silvia WJ: Eicosanoids. In: Knobil E, Neill JD.
Encyclopedia of reproduction. Academic Press, San Diego.
1998, p991-1001.
32. Smith G, Roberts R, Hall C, Nuki G: Reversible ovulatory
failure associated with the development of luteinized
unruptured follicles in women with inflammatory arthritis
taking non-steroidal anti-inflammatory drugs. Br J Rheumatol;
1996, 35: 458-462.
[Full Text]
33. Song H, Lim H, Das SK, Paria BC, Dey SK: Dysregulation
of EGF family of growth factors and COX-2 in the uterus
during the preattachment and attachment reactions of the
blastocyst with the luminal ephithelium correlates with
implantation failure in LIF-deficient mice. Mol Endocrinol;
2000, 14: 1147-1161.
[Full Text]
34. Stutz G, Martini AC, Ruiz RD, Fiol De Cuneo M, Muñoz L,
Lacuara JL: Functional activity of mouse sperm was not
affected by low doses of aspirin-like drugs. Arch Androl;
2000, 44: 117-128.
[Abstract]
35. Vincenti LM, Fiol De Cuneo M, Ruiz RD, Martini AC, Ponce
AA: Selection of high quality subpopulation of frozen thawed
bovine spermatozoa by filtration in a Sephadex column. J Exp
Anim Sci; 2002, 42: 93-101.
[Abstract]
36. Yanagimachi R: Mammalian fertilization. In: Knobil E,
Neill JD. The physiology of reproduction. Raven Press, New
York. 1994, p189-317.
37. Yelian FD, Dukelow WR: Effects of DNA-specific
fluorochrome, Hoechst 33258 on mouse sperm motility and
fertilizing capacity. Andrologia; 1992, 24: 167-170.
[Abstract]
38. Yen SSC, Jaffe RB: Reproductive endocrinology:
physiology, pathophysiology and clinical management. WB
Sanders Company, Phyladelphia, USA, 1991.
39. Zanagnolo V, Dharmarajan AM, Endo K, Wallach EE: Effects
of acetylsalicylic acid (aspirin) and naproxen sodium (naproxen)
on ovulation, prostaglandin, and progesterone production in
the rabbit. Fertil Steril; 1996, 65: 1036-1043.
[Abstract]
Table
Table 1:
Summary of the treatments applied and parameters and animal
number evaluated.
Gender
|
Parameters
|
IBUPROFEN |
PIROXICAM |
A |
B |
C |
A |
B |
C |
C |
NSAIDs |
C |
NSAIDs |
C |
NSAIDs |
C |
NSAIDs |
C |
NSAIDs |
C |
NSAIDs |
Females |
Ovulation Index (induced) |
22 |
26 |
|
|
17 |
19 |
21 |
22 |
|
|
10 |
10 |
Ovulation Index (spontaneous) |
13 |
11 |
|
|
12 |
12 |
10 |
9 |
|
|
- |
- |
Oocyte maturity |
58 cells |
50 cells |
|
|
47 cells |
26 cells |
44 cells |
38 cells |
|
|
29 cells |
31 cells |
Spermatozoa migration* |
12 |
9 |
|
|
- |
- |
8 |
9 |
|
|
- |
- |
In vitro fertilization rate |
199 cells |
219 cells |
|
|
237 cells |
137 cells |
226 cells |
274 cells |
|
|
132 cells |
91
cells |
In vivo fertilization rate |
13 |
12 |
|
|
5 |
10 |
10 |
10 |
|
|
10 |
10 |
Litter size |
10 |
11 |
|
|
4 |
6 |
8 |
7 |
|
|
6 |
5 |
Plasma FSH levels |
13 |
8 |
|
|
10 |
11 |
- |
- |
|
|
- |
- |
Cyclooxigenase inhibition |
- |
- |
|
|
5 |
5 |
- |
- |
|
|
5 |
5 |
Males |
Sperm functional activity* |
|
|
37 |
30 |
7 |
7 |
|
|
20 |
18 |
9 |
7 |
In vitro fertilization rate |
|
|
196 cells |
171 cells |
121 cells |
117 cells |
|
|
89
cells |
126 cells |
94
cells |
124 cells |
In vivo fertilization rate |
|
|
23 |
16 |
14 |
16 |
|
|
18 |
14 |
14 |
12 |
Litter size |
|
|
3 |
7 |
3 |
6 |
|
|
6 |
3 |
2 |
2 |
Plasma FSH levels |
|
|
3 |
6 |
7 |
6 |
|
|
- |
- |
- |
- |
Plasma testosterone levels |
|
|
8 |
8 |
8 |
8 |
|
|
- |
- |
8 |
8 |
Cyclooxigenase inhibition |
|
|
- |
- |
5 |
5 |
|
|
- |
- |
5 |
5 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Ibuprofen: A, B, C: 0.56, 1.12, 1.68 mg/100 g/day
respectively. Piroxicam: A, B, C: 0.028, 0.056, 0.084
respectively. C: Control animals; NSAIDs: treated animals.
Values indicate the number of animals except when indicated
(cells = oocytes). *: differences in the final number of
animals consigned in results, can be explained by missing
values or statistically excluded ones.

Table 2:
Effects of nonsteroidal-antiinflammatory drugs (NSAIDs)
(ibuprofen or piroxicam) administration to adult female mice
upon in vitro or in vivo fertilization indices.
Variables
|
IBUPROFEN |
PIROXICAM |
doses A |
doses C |
doses A |
doses C
|
Control
|
NSAIDs |
Control |
NSAIDs |
Control |
NSAIDs |
Control |
NSAIDs |
% of in vitro fertilized oocytes |
81, 9%
(199) |
82.6%
(218) |
90.7%
(237) |
89.0%
(137) |
85.4%
(226) |
81.7%
(274) |
80.3%
(132) |
83.5%
(91) |
In vivo
% of pregnant mice |
76.9%
(13) |
91.7%
(12) |
80.0%
(5) |
60.0%
(10) |
80.0%
(10) |
70.0%
(10) |
70.0%
(10) |
65.0%
(10) |
Number of fetuses |
8.4 ± 0.4
(10)
|
9.5 ± 0.7
(11) |
9.2 ± 0.5
(4) |
8.5 ± 0.2
(6) |
9.6 ± 0.7
(8) |
8.1 ± 1.2
(7) |
9.2 ± 1.1
(6) |
9.0 ± 1.0
(5) |
Ibuprofen
(doses
A: 0.56 mg/100g/day or doses C: 1.68 mg/100g/day; i.p.) or
piroxicam (doses A: 0.028 mg/100g/day or doses C: 0.084
mg/100g/day; i.p.) were injected daily to adult female mice
for 35 days. Control animals were injected with the solvent
(propylene glycol or dimethylsulfoxide respectively) in the
same volume and period. In vitro fertilization indices, are
expressed as percentages of fertilized oocytes that were
obtained by ampullar puncture after induced superovulation.
In vivo fertilization indices are expressed as percentages
of pregnant mice after housing for 4 days (one oestral
cycle) with untreated males; 12 days after, females were
sacrificed and the number of fetuses was determined. Results
are expressed as percentages or Mean
±
SEM. In parentheses: number of oocytes or female mice
evaluated.

Table
3:
Functional
activity of spermatozoa obtained from the reproductive tract
from female mice (treated with ibuprofen or piroxicam) after
mating with untreated males.
SPERM VARIABLE
|
IBUPROFEN |
PIROXICAM |
CONTROL UTERUS |
CONTROL OVIDUCT |
UTERUS |
OVIDUCT |
CONTROL UTERUS |
CONTROL OVIDUCT |
UTERUS |
OVIDUCT |
Progressive (%) |
45.7
±
6.1 a
(12) |
20.0
±
11.5 a
(3) |
46.2
±
5.7 b
(9) |
7.0
±
7.0 b
(2) |
43.6
±
6.5
(8) |
25.0
±
14.4
(3) |
22.9
±
8.3
(9) |
--- |
Non-progressive (%) |
10.5
±
2.9
(12) |
13.3
±
6.7
(3) |
12.8
±
2.7
(9) |
13.5
±
13.5
(2) |
12.9
±
2.1
(8) |
11.0
±
11.0
(3) |
15.8
±
4.8
(9) |
___ |
Non-motile (%) |
43.7
±
5.1 c
(12) |
66.7
±
17.6 c
(3) |
41.1
±
5.7 d
(9) |
79.5
±
6.5 d
(2) |
43.6
±
5.1
(8) |
64.0
±
7.4
(3) |
61.2
±
8.9
(9) |
___ |
Viable (%) |
47.7
±
6.3 e
(12) |
24.3
±
5.0 e
(10) |
49.6
±
6.6 f
(10) |
27.1
±
6.9 f
(7) |
56.9
±
6.2 g
(8) |
33.1
±
5.6 g
(7) |
40.0
±
7.0 h
(9) |
18.4
±
3.4 h
(5) |
Acrosome reacted (%) |
51.4
±
10.2
(11) |
70.3
±
13.0
(6) |
54.1
±
12.2
(9) |
74.1
±
7.5
(8) |
33.3
±
2.7 i
(7) |
55.5
±
4.7 i
(8) |
32.4
±
6.0 j
(7) |
60.3
±
8.3 j
(5) |
Ibuprofen
(doses A: 0.56 mg/100g/day; i.p.) or piroxicam (doses A:
0.028 mg/100g/day; i.p.) were administered to adult female
mice during 35 days. Control animals were injected with the
solvent (propylene glycol or dimethylsulfoxide respectively)
in the same volume and period. The spermatozoa were
evaluated 110 min after the female accepted the untreated
male for mating. Values indicate Mean
±
SEM. In parentheses: number of animals evaluated. In each
row, identical letters indicate significant differences (p<
0.05).

Table 4:
Effects of ibuprofen administration to adult female or male
mice upon percentages of radioconversion of arachidonic acid
to prostaglandins in uterus or seminal vesicles.
ARACHIDONIC ACID METABOLITES |
%
OF RADIOCONVERSION |
UTERUS |
SEMINAL
VESICLES |
CONTROL
(5) |
IBUPROFEN
(5) |
CONTROL
(5) |
IBUPROFEN
(5) |
6
– ceto - PGF1a
|
4.74
±
0.64 |
5.36
±
3.27 |
7.44
±
1.57 |
7.36
±
1.53 |
PGF2a |
3.84
±
0.33 |
3.76
±
0.18 |
6.37
±
1.16 |
6.72
±
1.49 |
PGE2 |
3.82
±
0.19 |
4.18
±
0.29 |
11.21
±
2.32 |
11.96
±
2.45 |
TXB2 |
2.37
±
0.24 |
2.62
±
0.15 |
4.50
±
0.78 |
5.60
±
1.55 |
Ibuprofen
(doses C: 1.68 mg/100g/day; i.p.) was administered to adult
female mice for 35 days and to adult male mice for 60 days.
Control animals were injected with the solvent (propylene
glycol) in the same volume and period. PG: prostaglandin;
TX: tromboxan. Values indicate Mean
±
SEM. In parentheses: number of animals evaluated.

Table 5:
Effects of nonsteroidal-antiinflammatory drugs (NSAIDs)
(ibuprofen or piroxicam) administration to adult male mice
upon functional activity of epididymal spermatozoa.
SPERM VARIABLE
|
IBUPROFEN
|
PIROXICAM
|
CONTROL
|
NSAIDs |
CONTROL |
NSAIDs |
|
27.6
±
0.5
(24) |
27.5
±
0.5
(19) |
26.7
±
1.1
(10) |
26.5
±
0.5
(13) |
Concentration (x 106/ml) |
11.6
±
0.9
(37) |
11.1
±
1.0
(30) |
15.3
±
1.9
(20) |
14.6
±
2.1
(18) |
Motile (progressive + non-progressive) (%) |
63.7
±
2.2
(30) |
62.8
±
2.8
(29) |
74.2
±
2.0
(17) |
67.2
±
3.1
(18) |
Viable (%) |
71.3
±
2.1
(16) |
71.7
±
2.2
(16) |
73.2
±
1.3
(17) |
75.6
±
2.4
(18) |
Swollen (HOST) (%) |
60.3
±
3.1
(17) |
57.5
±
3.6
(15) |
69.9
±
1.4
(17) |
69.4
±
2.2
(17) |
Acrosome intact (%) |
78.9
±
1.1
(8) |
77.4
±
3.5
(8) |
88.4
±
1.4
(9) |
88.9
±
1.2
(10) |
Bending and/or with cytoplasmatic drop (%) |
17.0
±
1.9
(16) |
17.4
±
2.0
(19) |
14.4
±
1.7
(24) |
17.4
±
2.3
(22) |
Ibuprofen
(doses B: 1.12 mg/100g/day; i.p.) or piroxicam (doses B:
0.056 mg/100g/day; i.p.) were administered to adult male
mice for 60 days. Control animals were injected with the
solvent (propylene glycol or dimethylsulfoxide respectively)
in the same volume and period. The spermatozoa were obtained
from the caudal epididymis. Values indicate Mean
±
SEM. In parentheses: number of animals. HOST= hypoosmotic
swelling test.

Table 6:
Effects of nonsteroidal-antiinflammatory drugs (NSAIDs)
(ibuprofen or piroxicam) administration to adult male mice
upon in vitro or in vivo fertilization indices.
Variables
|
IBUPROFEN |
PIROXICAM |
doses B |
doses C |
doses B |
doses C
|
Control
|
NSAIDs |
Control |
NSAIDs |
Control |
NSAIDs |
Control |
NSAIDs |
% of in vitro fertilized oocytes |
73.5%a
(196) |
59.1%a
(171) |
66.1%
(121) |
62.4%
(117) |
80.9%
(89) |
73.8%
(126) |
83.0%
(94) |
85.5%
(124) |
% of pregnant mice |
13.0%
(23) |
43.7%
(16) |
21.4%
(14) |
37.5%
(16) |
33.3%
(18) |
21.4%
(14) |
14.3%
(14) |
16.7%
(12) |
litter size |
7.0 ± 1.5
(3)
|
7.9 ± 1.0
(7) |
8.7 ± 0.3
(3) |
7.8 ± 1.2
(6) |
6.8 ± 1.6
(6) |
3.3 ± 0.9
(3) |
7.5 ± 2.5
(2) |
8.5 ± 0.5
(2) |
Ibuprofen (doses
B: 1.12 mg/100g/day or doses C: 1.68 mg/100g/day; i.p.) or
piroxicam (doses B: 0.056 mg/100g/day or doses C: 0.084
mg/100g/day; i.p.) were injected to adult male mice for 60
days. Control animals were injected with the solvent
(propylene glycol or dimethylsulfoxide respectively) in the
same volume and period. In vitro fertilization indices, are
expressed as percentages of fertilized oocytes that were
obtained by ampullar puncture after induced superovulation.
In vivo fertilization indices are expressed as percentages
of untreated pregnant mice after housing for 4 days (one
estral cycle) with treated males; 12 days after, females
were sacrificed and the number of fetuses was determined.
Results are expressed as percentages or Mean
±
SEM. In parentheses: number of oocytes or female mice
evaluated. a= p< 0.05.

Fig. 1
_chronic_archivos/image002.gif)
Figure 1:
Ovulation indices (number of oocytes/female) of adult female
mice injected for 35 days with ibuprofen
(doses A: 0.56 mg/100g/day or doses C: 1.68 mg/100g/day; i.p.).
Control animals were injected with the solvent (propylene
glycol) in the same volume and period. The oocytes were
obtained by ampullar puncture after induced superovulation
(PMS – hCG; induced) or after oestrus determination
(spontaneous). Results are expressed as Mean
±
SEM. In the bottom of the bars: number of female mice
evaluated. *= significant differences vs control (p< 0.05).

HEAD PAGE:
Chronic NSAIDs treatment and mouse reproductive functions

|