Evaluation of the Effect of Antioxidant Treatment on Seminal Parameters of Pubertal Patients with Beta Thalassemia Major

Abstract

Beta thalassemia syndromes are a group of hereditary disorders characterized by genetic deficiency in the synthesis of beta-globin chains. In the homozygous state, beta thalassemia major causes severe transfusion-dependent anemia. Free radicals and other reactive oxidants are generated in biological systems by both endogenous processes and exposure to external stimuli such as radiation, nitrogen oxides, mineral fibers and dusts. Reactive oxygen species (ROS) include superoxide anion (O2−), hydrogen peroxide (H2O2) and hydroxyl radical (HO•). Experimental data confirm the progression of oxidative stress in patients with β-thalassemia major due to activation of free radical processes and lipid peroxidation and decreased antioxidant capacity. The aim of this study was to determining the magnitude of oxidative damage of sperms in thalassemic patients after long period of repeated blood transfusions and assessment of the effect of antioxidant treatment by reassessment of sperm parameters after 6 months of treatment. Patients and Methods: Total number of patients screened to be included in the study was 125 patients with beta thalassemia major who were regularly attending the hematology/oncology clinic at Ain Shams University Hospitals. Fully pubertal thalassemic adults above 16 years with no endocrinal affection, particularly diabetes mellitus and hypothyroidism, were included. An informed consent was taken from the patients. Only 10 patients fulfilled the inclusion criteria and were compared to 10 other patients who were found to be azoospermic regarding their hormonal profile and anthropometric measures. The medical records of patients were reviewed and a standardized data sheet was completed for all study subjects. The collected data included: history, clinical examination, laboratory evaluation including: Initial assessment of serum calcium, phosphorous, assessment of serum parathyroid hormone, assessment of serum thyroid stimulating hormone and serum free thyroxin, assessment of fasting serum glucose and fasting serum insulin, assessment of basal serum follicle stimulating hormone and serum luteinizing hormone, initial semen analysis including seminal volume, color, sperm count, motility, abnormal forms and types of abnormality and comparison to the WHO reference ranges, sperm chromatin structure assay test to assess sperm DNA damage initially, assessment of superoxide dismutase, glutathione peroxidase and reductase levels in seminal plasma.