Management of low male fertility potential with probiotics (Lactobacillus rhamnosus PB01): a novel approach in male sub-fertile patients

Infertility is defined by the WHO as "inability to achieve pregnancy within a year for a sexually active couple without the use of contraceptive contraception" and represents a global problem. Epidemiological reports show that approximately 10% of the global reproductive population is classified as infertile. Male fertility accounts for about 50% of the cause of infertility in the last decade, which gives cause for serious concern when looking at the reported decline in sperm quality in recent years. Being overweight in adult men has been associated with low sperm count in recent years and a significant increase in the incidence of infertility has been observed in obese male patients. Testosterone deficiency in obese men may be a contributor to decreased sperm count, resulting in a lower number of normal, moving sperm, and lower total sperm count (TSC), whichresults in a higher frequency of men diagnosed with oligozoospermia. Previous findings strongly suggest that intestinal flora contributes to complications related tofood intake and metabolic disorders. In addition, the use of probiotics also mimics the most important aspects of microbial symbiosis, which improves reproductive fitness in mammals. A recent study of Valcarce et al. has provided preliminary evidence that 6 weeks of supplementation of oral probiotics(Lactobacillus rhamnosus CECT8361 and Bifidobacterium longum CECT7347) can significantly improve sperm motility while reducing DNA fragmentation as well as levels of reactive oxygen compounds (ROS) in asthenozoospermic men. Another recent study, conducted by members of our own group, examined the effect of probiotic on male fertility potential in a diet-induced obesity mouse model. The study demonstrated that mice that had undergone diet-induced obesity (DIO) receiving probiotiarysupplementation , had a significantly higher percentage of non-progressive (P<0.05) and progressively motil (P<0.01) semen, as well as significantly lower percentage of immotil semen (P<0.01) compared to the DIO group without probiotics supplementation. The detailed kinematic parameters of the sperm cell (curvedspeed (VCL), average track speed (VAP), straight speed(VSL), stroke cross frequency (BCF) and lateral headdisplacement amplitude (ALH)) also demonstrated higher mean values in the probiotic supplemented DIO groups. Both DIO and normal groups supplemented with probiotics in this study demonstrated higher testosterone, LH and FSH levels after 4 weeks of probioticsa-supplementation. The said study generally showed that Lactobacillus rhamnosus PB01 (DSM 14870) could induce weight loss, and positively affect specific biomarkers for male fertility potential, including sperm motility parameters and hormone levels in a diet-induced obesity model. The hormonal balance and change in the detected sperm speed and movement parameters were established to be associated with the direct effect of probiotics on the spermatogenesis and maturation process, or indirectly by eliminating the harmful effects of obesity and increasing the level of total antioxidant capacity. The hormonal balance induced by probiotics could also play a positive role in improving sperm motility parameters. The present study aims to transfer the results of previous studies in experimental animals to humans and to examine whether the oral supplementation of the probiotic L. rhamnosus PB01 (DSM 14870) could have a positive effect on the sperm quality parameters, as well as the reproductive hormone levels in men with reduced sperm quality.

sperm quality, infertility, probiotic