Antimalarial Therapies and Infertility:A Comprehensive Review

Abstract

Apart from other factors associated with infertility, scientific literatures had shown that synthetic and herbal antimalarial agents are also associated with reproductive disorders. However, there is paucity of review update on the reproductive toxicity posed by these antimalarial agents. With the aid of the internet data base, relevant literatures on this subjects matter were reviewed in this evaluation. Among the synthetic and herbal antimalarials investigated, Quinine, Piperaquine phosphate, Chloroquine, Proguanil, halofantrine hydrochloride, Pyrimethamine, Arthemeter- Lumefantrine, ACTs (artesunate), Artemether, Azadirachta indica (Neem), Phyllanthus amarus, Alstonia boonei , except (sulfadoxine/pyrimethamine), were associated with diverse reproductive toxicities. Proposed mechanisms of such toxicities include; reduction in follicle stimulating hormone, leuteinizing hormone and testosterone levels, impairments in sperm parameters, antifolate (Pyrimethamine) activity, anti-androgenic activity, distortion of the blood-testis barrier formed by the sertoli cells and increase reactive oxygen species (ROS). On this basis, antimalarial therapies (synthetic and medicinal plants) should be used with caution, especially during pregnancy. Also, reproductive toxicities of new antimalarial drugs being launched into the marked should be screened to ascertain their safety.