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We report the first case of a man with normal fertility and mild hyper-androgenism who experienced a persistent negative sperm motility after treatment with clozapine. A 25-year-old female patient, with no other predisposing factors, was referred to our laboratory due to the presence of spermatogenic cells in a small ejaculate. The patient had no history of gastrointestinal disease or liver disease. Her semen analysis was negative for alanine transaminase, glucose, and other electrolytes, but her serum levels of vitamin B12 were within normal limits. Her serum levels of testosterone were within the normal range and she was treated with clozapine (30 mg/day) for 4 months. During her follow-up, no significant adverse effects on sperm motility were observed. We conclude that clozapine may be an effective treatment for infertility, but it may not be the first choice for many couples. It may be necessary to consider alternative treatments in patients with unexplained infertility who have not responded to conventional fertility treatments.
In a study of 25 patients with unexplained infertility, we reported on the results of the first author’s (J. P.) sperm motility test and found a normal morphology. The results are shown in.
In our previous study, we reported that in the semen analysis of the first author’s sperm, sperm with normal morphology were detected in only 4.4% of the patients and in 2.6% of the patients with a mild positive sperm motility test. In our study, we have reported a positive result in only one patient and in one patient with mild positive motility. However, we did not report a positive result in the semen analysis. A possible explanation for this difference is that in our previous study, spermatozoa were not isolated in the semen analysis of the first author. The spermatozoa were not isolated in our previous study and the present study is the only study that reports the presence of spermatozoa in the semen analysis of the first author. Our previous study reported a negative result in all patients. The sperm motility test is usually performed by using a sample of semen obtained from the patient. A positive result is usually positive when a semen analysis is negative. However, a negative result is usually not detected when a semen analysis is positive.
The present study suggests that Clozapine (ciprofloxacin) may be effective for the treatment of infertility in men with mild hyper-androgenism. This could be due to its pharmacological action. The positive result in our study may be due to the effect of clozapine on spermatogenesis.
Citation:Wang J, Lee S, Park E, Park G, et al. (2021) A new approach for the diagnosis of male infertility. PLoS ONE 15(10): e0199097. https://doi.org/10.1371/journal.pone.0199097
Editor:F. E. C. Johnson, University of North Carolina, Chapel Hill, United States of America
Received:February 20, 2021;Accepted:June 14, 2021;Published:July 1, 2021
Copyright:© 2021 Wang et al. This is an open access article distributed under the terms of the, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Data Availability:All relevant data are within the paper and its Supporting Information files.
Funding:This work was supported by grants from the Korean Society for Promotion of Chemical Analyses, the Korea Health R& D Institute, and the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Competing interests:The authors have declared that no competing interests exist.
Fertility. Fertility is a common occurrence in both men and women. Men with male factor infertility usually have poor sperm counts or poor sperm motility. They usually do not ejaculate regularly or have poor sperm morphology (e.g., poor sperm motility or motility lacking certain sperm parameters).
This medicine is a prescription only medicine and must be given by a veterinarian.
Aquaflox-Ciprofloxacin Oral Suspension 1.25 mL for Veterinary Reference PackAquaflox-Ciprofloxacin Oral Suspension 10 mL for Animal UseAquaflox-Ciprofloxacin Oral Suspension 10 mL for Veterinary Reference PackThe Quinolone Drug is a Class of Antibiotics that treats and treats bacterial infections in animals. It works by stopping the growth and multiplication of bacteria and other microorganisms. It also treats infections that result in tissue destruction, inflammation (swelling, redness), and infections (e.g., ear infections, sinusitis).Aquaflox-Ciprofloxacin Oral Suspension 2.5 mL for Veterinary Reference PackAquaflox-Ciprofloxacin Oral Suspension 5 mL for Animal UseCiprofloxacin-Difloxacin Oral Suspension 1.25 mL for Animal UseCiprofloxacin-Difloxacin Oral Suspension 10 mL for Animal UseThe Ciprofloxacin Drug is a Class of Drugs That Treat Bacterial Infections. It works by stopping the growth and multiplication of microorganisms. It also treats infections resulting in tissue destruction, inflammation (swelling, redness), and infections (e.g.In vitro studies on the effects of oral administration of Ciprofloxacin on renal and hepatic metabolism of loratadine were conducted in mice. A single intraperitoneal injection of Ciprofloxacin significantly reduced the clearance of urinary excretion of loratadine. There was no evidence of drug interference in renal tubular metabolism of loratadine in both species. Larger increases were seen in loratadine and urine excretion of unchanged drug and loratadine were recovered in unchanged drug. These results suggest that the bioavailability of Ciprofloxacin is reduced by its administration to patients with kidney disease. This may be related to the increased renal clearance of loratadine, which may be a consequence of its renal effects on drug absorption.
Clinical pharmacokinetics of loratadine in normal and diseased mice are not affected by chronic administration of loratadine. Larger increases of loratadine and urine excretion of unchanged drug and loratadine were seen in the groups of normal and diseased mice.
Dose adjustment is recommended for patients with severe renal impairment. The results of the clinical pharmacokinetic studies were similar to those seen in healthy volunteers. The clearance of loratadine was increased by 30%. The increase in the clearance of loratadine was not observed in the healthy volunteers. The maximum plasma concentration (Cmax) and the area under the curve (AUC) for loratadine in healthy volunteers was 1.25 to 2.12 times higher than those seen in the patients. The results suggest that loratadine is excreted predominantly in the urine and is associated with a greater degree of urinary excretion of loratadine. This may be related to the greater clearance of loratadine in patients with renal impairment.
The effect of oral administration of Ciprofloxacin on the clearance of urinary excretion of loratadine was not affected by the presence of food. The results of the clinical pharmacokinetic studies with Ciprofloxacin were similar to those seen in healthy volunteers.
The results of clinical pharmacokinetic studies with Ciprofloxacin are shown in.
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