Epilepsy And The Effect Of Antiepileptic Drugs On The Male Reproductive System And Mechanism Research

Through clinical and animal experiment to discuss the Effects of epilepsy and AEDS on reproductive system in Chinese male epilepsy patients.firstly, To investigate the effects of sodium valproate on reproductive endocrine, sexual function and spermatozoa, and the possible etiological mechanisms in Chinese male epilepsy patients. Secondly, using licl-horse cards establish male Wistar rats epilepsy mode, analyzing the Effects of epilepsy and AEDS on male rats reproductive system and provide theoretical evidence to discusses the pathogenic mechanism.Part I Effects of sodium valproate on reproductive endocrine, sexual function and sperm parameters in Chinese ethnic Han male epilepsy patientsPurpose:To investigate the effects of sodium valproate on reproductive endocrine, sexual function and spermatozoa, and the possible etiological mechanisms in Chinese ethnic Han male epilepsy patients. Methods:Patient’s serum and sperm samples were collected and sexual function scale was used to evaluate the respective changes in patient’s reproductive endocrine, sperm parameters and sexual function.Key Findings:LH and FSH levels were significantly lower, while BAT/LH ratio and PRL level were significantly higher in VPA treatment group than in control group; there were no significant changes in T and E2levels and BAT/BAE ratio. No clear abnormalities in semen concentration were observed between epilepsy treatment group and control group. Sperm morphologic abnormality rate (head, body and tail) was significantly higher in epilepsy treatment group than in control group, especially with the most significant head deformity. The sperm motility rate was significantly lower with patients in epilepsy treatment group (grade A sperm motility rate<25%, sperm motility rate<50%, grade A+B sperm motility rate) than wth healthy subjects in control group. When comparing IIEF-5scores with healthy subjects in control group, patients in VPA treatment group performed clearly poorer in response to questionnaires1,2and3, showed no significant difference in response to questionnaires4and5, and had significantly lower final total scores.Significance:VPA treatment has varying degree of adverse impacts on reproductive endocrine, sperm parameters and sexual function in male Chinese epilepsy patients. Part Ⅱ Epilepsy on male wistar rats reproductive effects of Experimental study objective study epilepsy on male wistar rats reproductive effects of relevant indicators, provides Suggestions to improve clinical epilepsy male patients birth quality. Methods using licl-horse cardsestablish male Wistar rats epilepsy mode,take Blood sampling, testis and epididymis, sperm were measured serum sex hormones, viscera coefficient, sperm counts, sperm motility and morphology, take testis and epididymis tissue to observe changes of pathology and ultrastructural analyzing epilepsy on male rats reproductive effects. Results the success group of Epilepsy made and the Without success group of Epilepsy made’s total testosterone (TT) and progesterone (P) levels were significantly lower than healthy group.the success group of Epilepsy TT level is significantly below the Without success group of Epilepsy made, epilepsy made mould success rats,progesterone (P) level and epilepsy made mode without success group without obvious difference. Epilepsy made module LH and FSH were significantly higher build mode without success group and control group, Epilepsy made mould success rats, PRL were significantly higher than epilepsy made mode without success group and healthy controls, E2in three groups nonsignificant between-group difference. Epilepsy made mould successful group and healthy controls and epilepsy build mode without success group compared testicular visceral index (testicles weight/body weight) there are significant differences. Epilepsy made module rats sperm count is lower than controls and epilepsy build mode without success group, Sperm activity rate of Epilepsy made module and epilepsy build mode without success group are lower than healthy controls, Epilepsy made module and build mode without success group can find out more sperm head deformity, in light microscopy, Group A and B rats testicular sperm cells Basic neatly arranged, Structure has not seen the obvious disorder phenomenon, sperm cells levels decrease at some different levels, number of Sperm are decrease in Testicular seminiferous tubule and watch dead spermatogenic cell, Leydig structure is absent and Leydig cell Significantly reduce. in Group A, the structure of epididymis’Tube BiZhu cells、basilar cells and microvilli are clear and tidy.but Sperm counts are significantly reduce and Other cells appear in epididymal lumen. in Group B, Sperm counts have no change and Other cells scattered appear in epididymal lumen.in Electron microscopy, in Electron microscopy, spermatogenic cell nucleus Obviously deformity, Mitochondria Ridge disappear and Markedly swollen, rough endoplasmic reticulum also obviously swollen, cell nucleus of sperm is clear but perforatorium apicle is irregular. The Structure of Sperm tail is normal but the Mitochondria scabbard is significantly swollen and reduced.the same results can found in group B at Different degrees. In group A and B,there have not found obviously disorder in epididymis chief cell, meanwhile endoplasmic reticulum are all in markedly swollen state. Conclusion licl-horse cards establish male Wistar rats epilepsy mode have obviously influenced on the reproductive system related indexes,show that epilepsy itself have a certain extent to the reproductive system. Part Ⅲ Carbamazepine on male wistar rats reproductive effects of Experimental study Objective study the effects of CBZ and CBZ with epilepsy on reproductive system of male wistar rats. Methods using licl-horse cards establish male Wistar rats epilepsy mode and Health Wistar rats male controls which were given three different concentration carbamazepine irrigation stomach, take Blood sampling, testis and epididymis, sperm were measured serum sex hormones, viscera coefficient, sperm counts, sperm motility and morphology, take testis and epididymis tissue to observe changes of pathology and ultrastructural analyzing epilepsy on male rats reproductive effects. Results In the Epilepsy module rats were given High, medium and low concentration CBZ shows that LH、FSH、E2were significantly higher than controls, but no different between three concentration groups. progesterone (P) level of three concentration obviously lower than controls, but Low concentration group was significantly lower than the other two concentration groups. testosterone (T) level of three concentration groups were significantly lower than healthy group,no changes was found in PRL.in the health control Wistar rats were given High, medium and low concentration CBZ shows that LH、FSH were significantly higher than controls, testosterone (T) level of three concentration groups were significantly lower than health group, especially the High concentration group,PRL level of medium and low concentration group obviously lower than controls, there is no different in P、E2. There is no changes of Weight and Testicular weight and testicular viscera coefficient between male epilepsy rats and health group, but Epididymis weight and epididymis viscera coefficient is obviously lower in the health rats with three concentration CBZ than controls. no sperm count change in the three concentration of male epilepsy rats and health group, but both of them with the lower Sperm activity rate than controls, Especially high concentrations group. in light microscopy, the Epilepsy module rats were given High, medium and low concentration CBZ shows that Testicular seminiferous tubule of sperm cells structure, levels and the sperm cell and sperm number is progressive damage,The three concentration of epididymis group without obvious change in organization structure,but sperm count shows progressive decrease. The medium and low concentration of health rats show that Testicular seminiferous tubule structure has different degree sparse disorders,much of sperm cells can be seen in lumen and Sperm counts are significantly reduce, Epididymis organization almostly as same as normal. in Electron microscopy, testicular of epilepsy high concentration group can be seen Reproductive nuclei deformity cracking and organelles swelling and The medium concentration just saw Organelles swelling of empty bubble and low concentration has Testicular basement membrane uneven thickness. Epididymis of epilepsy high concentration group can be seen the dead sperm cells, The Epididymis of medium concentration can be found The head of sperm film falls off and Sperm tail coated wrinkle. the health rats were given High concentration show that Testicular seminiferous tubule structure has sparse disorders, organelles was seriously empty bubble, mitocondrialsheath around the body of Sperm Swelling, loss, number significantly less, he health rats were given medium concentration can be seen mitochondria of sperm cells have empty bubble phenomenon, high concentration group of health rats’ epididymis have seriously master cells of empty bubble and structure disorder, the medium concentration group of health rats’epididymis sperm film falls off. Conclusion Carbamazepine itself for male rats reproductive system exists obvious side effects and Drug concentration obviously relevance, both of Carbamazepine and epilepsy also presents the part of the side effects of correlation concentration,but Mechanism is relatively complex, caused by many factors for joint action.