Can Indomethacin Improve Male Fertility? Contrasting Evidence from Clinical Trials and Preclinical Studies

Male infertility represents a significant global burden, accounting for approximately ۲۰% of fertility cases. Due to the increasing consumption of analgesic drugs, the impact of such medications on specific aspects of the male reproductive system is an interesting area of research. Indomethacin is a non-steroidal anti-inflammatory drug (NSAID) primarily used in the treatment of moderate pain since ۱۹۶۰. The aim of this systematic review is to investigate whether indomethacin has clinical benefits in the treatment of male infertility. We searched PubMed, Medline, Cochrane Central Register of Controlled Trials (CENTRAL), and Scopus for relevant studies published from ۲۰۰۰ until December ۲۰۲۳ using combinations of the search terms 'indomethacin', 'male', 'infertility', 'sperm', 'testosterone' and their MeSH synonyms. Inclusion criteria were preclinical and clinical trial studies related to indomethacin and male infertility with text accessible in English. We excluded non-original articles, languages other than English, and studies with unclear data descriptions. The study was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines criteria. Overall, ۵ studies met the inclusion criteria, providing information on trials that evaluated the safety, adverse effects, and effectiveness of indomethacin, whether used alone or in combination with other medicines on male infertility. All clinical trials reported increased sperm count and sperm motility. However, preclinical studies demonstrated decreases in these indices. Additionally, two studies mentioned reductions in prostate weight and testosterone levels. Summary of the Results Reported by Human Clinical Trials stated improvements in sperm parameters. In contrast, preclinical data revealed negative impacts on reproductive qualities. Due to the limitations of studies in this area, more research is needed to investigate the safety and efficacy of indomethacin in relation to male infertility.

Keywords:

indomethacin , male , infertility , sperm , testosterone