Diabetes, oxidative stress and its impacts on male fertility

Objective. In male infertile patients with diabetes, there are growing evidences indicating important physiopathological connections between the mechanisms of oxidative damage in terms of rate of fragmentation of the nuclear DNA, deletions of the mithocondrial DNA, imbalance of the oxidative balance, increased levels of enzymatic glication products in testicular and epididimary region, and besides on the seminal plasma. Taken the above oxidative damage as secondary to a putative radical oxygen species hyperproduction, aim of this study was to directly assess the radical oxygen species production, in basal and after fMLP-addition (to evaluate maximal leukocyte response), in infertile, diabetic patients. To verify a relatively defective functional of radical oxygen species production, the pattern of radical oxygen species response in diabetic patients was compared to that found in two controls groups. Sperm conventional parameters, including seminal leukocytes concentration were also evaluated in patients and controls groups. Material and methods. In the present observational study, 18 selected, infertile patients with diabetes (mean age 36 years, range 28- 44 years) underwent semen analysis for assessment of radical oxygen species, sperm parameters (density, motility, morphology, and seminal leukocyte concentration). The results obtained were compared with the data obtained from two control groups (analysis among groups), including a group of 28 patients with male accessory gland infection and a group of 16 healthy, volunteers subjects. Results. The mean values of semen parameters of the infertile patients with diabetes were significantly different from those found in both control groups, being together better than those of the male accessory gland infections control group but worse than those of the healthy subjects. In addition, the infertile men with diabetes had higher radical oxygen species chemiluminescent signals in all conditions (baseline and fMLP-stimulated) than those registered in the healthy subjects but lower than those found in male accessory gland infections group. Conclusions. The infertile patients with diabetes studied characterized itself differing from the group with male accessory gland infections because the low leukocyte response in part, likely explained through an immuno-pathogenetic picture (defective macrophagic response) conditioned by the same basic disease. Despite in diabetic patients, the sperm oxidative stress seem less than that observed in presence of male accessory gland infections, this can likely explain their impaired sperm data.