Sperm DNA fragmentation: focusing treatment on seminal transport fluid beyond sperm production.

Aim: To determine the effects of oral antibiotics and anti-inflammatory agents on semen parameters and the sperm DNA fragmentation index (DFI).

Methods: Ninety-eight men with infertility diagnosis were included. The participants submitted two semen samples, before and at least two months after treatment. Macroscopic and microscopic semen parameters were evaluated following the World Health Organization (WHO) guidelines. In addition, the sperm DFI was evaluated using the sperm chromatin dispersion (SCD) technique. Subsequently, a treatment regimen was administered, including daily oral doses of ciprofloxacin (1000 mg) and doxycycline (100 mg) for 21 and 10 days, respectively. In addition, non-steroidal anti-inflammatory drugs (15 mg of meloxicam) were used for 10 days. After treatment, the same parameters were re-evaluated for new semen samples taken under the same initial conditions.

Results: After treatment, significant increases in pH, sperm count, total concentration, and normal sperm morphology were observed, but no significant differences were found in the seminal volume parameter or progressive motility. After treatment, a significant decrease in the concentration of immature cells was observed, and although not statistically significant, a reduction in the concentration of leucocytes was observed. After treatment, the mean sperm DFI significantly decreased from 28.24± 2.39% to 16.2±7.1%.

Conclusions: Treatment with antibiotics and anti-inflammatories significantly reduced the sperm DFI and improved semen quality.