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Impact of Duloxetine on Male Fertility

Rakstu tulkošanu var veikt tikai reģistrēti lietotāji
Ielogoties Reģistrēties
Saite tiek saglabāta starpliktuvē
StatussPabeigts
Sponsori
Weill Medical College of Cornell University

Atslēgvārdi

Abstrakts

The investigators are conducting a placebo-controlled, randomized control trial with duloxetine in healthy, fertile men not previously on any antidepressants. Participants will be randomized to either the duloxetine or placebo groups for 6 weeks. The investigators will assess changes in sperm DNA fragmentation at 0, 2, 6, 8, and 10 weeks. Other outcomes measured will include semen parameters (sperm concentration, motility, morphology), hormone levels (testosterone, estrogen, prolactin, LH, FSH), and sexual function (IIEF and MSHQ) surveys.

Apraksts

Antidepressant medications are commonly prescribed in the USA not only for depression, but also for anxiety disorders such as generalized anxiety disorder and obsessive-compulsive disorder, premature ejaculation, post-traumatic stress disorder, and neuropathic pain. Despite being widely prescribed in the United States in men of reproductive age, the impact of antidepressants on fertility has not been extensively studied.

After noticing worsened semen parameters in men on anti-depressants, the investigators performed the first prospective study to demonstrate a deleterious impact of selective serotonin reuptake inhibitors (SSRI) on sperm DNA integrity, which has been linked to reproductive outcomes. Further small studies have corroborated the negative impact of SSRIs on male fertility, as assessed by semen parameters and/or sperm DNA integrity.

No studies have examined the impact of a newer, but similar, class of antidepressant - the serotonin-norepinephrine reuptake inhibitor (SNRI). Like SSRIs, SNRIs inhibit the reuptake of serotonin, but also act on norepinephrine. The use of SNRIs has increased recently due to their slightly improved efficacy profile when compared to SSRIs. Duloxetine is an SNRI and is one of the most commonly prescribed anti-depressants in the United States.

The investigators are conducting this trial to determine whether or not the administration of duloxetine will result in a deterioration in sperm DNA fragmentation in healthy, fertile men.

Datumi

Pēdējoreiz pārbaudīts: 01/31/2020
Pirmais iesniegtais: 01/26/2017
Paredzētā reģistrācija iesniegta: 01/29/2017
Pirmais izlikts: 01/31/2017
Pēdējais atjauninājums iesniegts: 02/25/2020
Pēdējā atjaunināšana ievietota: 03/11/2020
Pirmo rezultātu iesniegšanas datums: 02/11/2020
Pirmo QC rezultātu iesniegšanas datums: 02/11/2020
Pirmo publicēto rezultātu datums: 02/25/2020
Faktiskais studiju sākuma datums: 12/11/2016
Paredzamais primārās pabeigšanas datums: 08/30/2018
Paredzamais pētījuma pabeigšanas datums: 08/30/2018

Stāvoklis vai slimība

Infertility, Male
Depression

Iejaukšanās / ārstēšana

Drug: Duloxetine

Drug: Placebo

Fāze

Fāze 2

Roku grupas

RokaIejaukšanās / ārstēšana
Experimental: Duloxetine
Duloxetine orally 60mg daily for 5 weeks, then taper to 30mg daily for 1 week
Drug: Duloxetine
Duloxetine orally 60mg daily for 5 weeks, then taper to 30mg daily for 1 week
Placebo Comparator: Placebo
Placebo
Drug: Placebo
Placebo orally 2 tabs daily for 5 weeks, then taper to 1 tab daily for 1 week

Atbilstības kritēriji

Vecums, kas piemērots studijām 18 Years Uz 18 Years
Dzimumi, kas ir piemēroti studijāmMale
Pieņem veselīgus brīvprātīgos
Kritēriji

Inclusion Criteria:

- Healthy men aged 18-65 years old;

- normal or borderline semen analysis (sperm concentration > 10 million/mL, sperm motility > 30%, sperm morphology > 3%);

- willing to engage in sexual activity (alone or with a partner) at least once per week for the duration of the study;

- capable of providing semen sample.

Exclusion Criteria:

- Clinically detected varicocele;

- oligoasthenoteratospermia or azoospermia on semen analysis;

- ongoing attempts to initiate pregnancy;

- current sexual dysfunction (classified as moderate or worse on IIEF);

- history of seizure disorder;

- history of previous chemotherapy or radiation therapy;

- current psychiatric history or history of bipolar disorder;

- family history of bipolar disorder, depression, or suicide;

- use of any psychotropic medications or anticonvulsants;

- use of sleeping pills more than once per week;

- use of any hormonal medications on a daily or intermittent basis during the preceding 3 months;

- use of medications which may affect hormone measures and/or sexual function;

- inability to read, follow instructions, or complete questionnaires in English;

- consumption of tobacco or illicit drugs;

- consumption of >2oz of alcohol daily.

Rezultāts

Primārie rezultāti

1. Number of Participants With Abnormal Sperm DNA Fragmentation at 6 Weeks [6 Weeks (primary time point of interest)]

Number of participants with TUNEL values > 25% at 6 weeks in each treatment group

2. Number of Participants With Abnormal Sperm DNA Fragmentation at 0 Weeks [0 weeks]

Number of participants with Tunel Values > 25% at 0 Weeks (baseline) in each treatment group

3. Number of Participants With Abnormal Sperm DNA Fragmentation at 2 Weeks [2 weeks]

Number of participants with Tunel values > 25% at 2 weeks in each treatment group

4. Number of Participants With Abnormal Sperm DNA Fragmentation at 8 Weeks [8 weeks]

Number of participants with Tunel values > 25% at 8 weeks in each treatment group

5. Number of Participants With Abnormal Sperm DNA Fragmentation at 10 Weeks [10 Weeks]

Number of participants with Tunel values > 25% at 10 weeks in each treatment group

Sekundārie iznākuma mērījumi

1. Sperm Concentration at 0 Weeks [0 weeks]

Sperm concentration (number of sperm/mL) in semen analysis at 0 weeks

2. Sperm Concentration at 2 Weeks [2 weeks]

Sperm concentration (number of sperm/mL) in semen analysis at 2 weeks

3. Sperm Concentration at 6 Weeks [6 weeks]

Sperm concentration (number of sperm/mL) in semen analysis at 6 weeks

4. Sperm Concentration at 8 Weeks [8 weeks]

Sperm concentration (number of sperm/mL) in semen analysis at 8 weeks

5. Sperm Concentration at 10 Weeks [10 Weeks]

Sperm concentration (number of sperm/mL) in semen analysis at 10 weeks

6. Sperm Motility at 0 Weeks [0 weeks]

Sperm motility (mean percent) at 0 weeks

7. Sperm Motility at 2 Weeks [2 weeks]

Sperm motility (mean percent) at 2 weeks

8. Sperm Motility at 6 Weeks [6 weeks]

Sperm motility (mean percent) at 6 weeks

9. Sperm Motility at 8 Weeks [8 weeks]

Sperm motility (mean percent) at 8 weeks

10. Sperm Motility at 10 Weeks [10 Weeks]

Sperm motility (mean percent) at 10 weeks

11. Sperm Head Defects at 0 Weeks [0 weeks]

Sperm head defects (mean number) at 0 weeks

12. Sperm Head Defects at 2 Weeks [2 weeks]

Sperm head defects (mean number) at 2 weeks

13. Sperm Head Defects at 6 Weeks [6 weeks]

Sperm head defects (mean number) at 6 weeks

14. Sperm Head Defects at 8 Weeks [8 weeks]

Sperm head defects (mean number) at 8 weeks

15. Sperm Head Defects at 10 Weeks [10 Weeks]

Sperm head defects (mean number) at 10 weeks

16. Sperm Neck Defects at 0 Weeks [0 weeks]

Sperm neck defects (mean number) at 0 weeks

17. Sperm Neck Defects at 2 Weeks [2 weeks]

Sperm neck defects (mean number) at 2 weeks

18. Sperm Neck Defects at 6 Weeks [6 weeks]

Sperm neck defects (mean number) at 6 weeks

19. Sperm Neck Defects at 8 Weeks [8 weeks]

Sperm neck defects (mean number) at 8 weeks

20. Sperm Neck Defects at 10 Weeks [10 Weeks]

Sperm neck defects (mean number) at 10 weeks

21. Sperm Tail Defects at 0 Weeks [0 weeks]

Sperm tail defects (mean number) at 0 weeks

22. Sperm Tail Defects at 2 Weeks [2 weeks]

Sperm tail defects (mean number) at 2 weeks

23. Sperm Tail Defects at 6 Weeks [6 weeks]

Sperm tail defects (mean number) at 6 weeks

24. Sperm Tail Defects at 8 Weeks [8 weeks]

Sperm tail defects (mean number) at 8 weeks

25. Sperm Tail Defects at 10 Weeks [10 Weeks]

Sperm tail defects (mean number) at 10 weeks

26. Testosterone Level at 0 Weeks [0 weeks]

Testosterone level (ng/dL) at 0 weeks

27. Testosterone Level at 2 Weeks [2 weeks]

Testosterone level (ng/dL) at 2 weeks

28. Testosterone Level at 6 Weeks [6 weeks]

Testosterone level (ng/dL) at 6 weeks

29. Testosterone Level at 8 Weeks [8 weeks]

Testosterone level (ng/dL) at 8 weeks

30. Testosterone Level at 10 Weeks [10 Weeks]

Testosterone level (ng/dL) at 10 weeks

31. Estrogen Level at 0 Weeks [0 weeks]

Estrogen level (pg/mL) at 0 weeks

32. Estrogen Level at 2 Weeks [2 weeks]

Estrogen level (pg/mL) at 2 weeks

33. Estrogen Level at 6 Weeks [6 weeks]

Estrogen level (pg/mL) at 6 weeks

34. Estrogen Level at 8 Weeks [8 weeks]

Estrogen level (pg/mL) at 8 weeks

35. Estrogen Level at 10 Weeks [10 Weeks]

Estrogen level (pg/mL) at 10 weeks

36. Prolactin Level at 0 Weeks [0 weeks]

Prolactin level (ng/mL) at 0 weeks

37. Prolactin Level at 2 Weeks [2 weeks]

Prolactin level (ng/mL) at 2 weeks

38. Prolactin Level at 6 Weeks [6 weeks]

Prolactin level (ng/mL) at 6 weeks

39. Prolactin Level at 8 Weeks [8 weeks]

Prolactin level (ng/mL) at 8 weeks

40. Prolactin Level at 10 Weeks [10 Weeks]

Prolactin level (ng/mL) at 10 weeks

41. Luteinizing Hormone Level at 0 Weeks [0 weeks]

Luteinizing hormone level (mIU/mL) at 0 weeks

42. Luteinizing Hormone Level at 2 Weeks [2 weeks]

Luteinizing hormone level (mIU/mL) at 2 weeks

43. Luteinizing Hormone Level at 6 Weeks [6 weeks]

Luteinizing hormone level (mIU/mL) at 6 weeks

44. Luteinizing Hormone Level at 8 Weeks [8 weeks]

Luteinizing hormone level (mIU/mL) at 8 weeks

45. Luteinizing Hormone Level at 10 Weeks [10 Weeks]

Luteinizing hormone level (mIU/mL) at 10 weeks

46. Follicle Stimulating Hormone Level at 0 Weeks [0 weeks]

Follicle stimulating hormone level (mIU/mL) at 0 weeks

47. Follicle Stimulating Hormone Level at 2 Weeks [2 weeks]

Follicle stimulating hormone level (mIU/mL) at 2 weeks

48. Follicle Stimulating Hormone Level at 6 Weeks [6 weeks]

Follicle stimulating hormone level (mIU/mL) at 6 weeks

49. Follicle Stimulating Hormone Level at 8 Weeks [8 weeks]

Follicle stimulating hormone level (mIU/mL) at 8 weeks

50. Follicle Stimulating Hormone Level at 10 Weeks [10 Weeks]

Follicle stimulating hormone level (mIU/mL) at 10 weeks

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