Avoiding Infertility after Spinal Cord Injury by Hyperbaric Oxygenation Therapy

Abstract

Introduction After a primary mechanical injury in the spinal cord, a cascade of inflammatory events is triggered leading to the degeneration and death of potentially viable neuronal tissue. Besides motor loss, the injured patients suffer from erectile and ejaculatory dysfunctions, and spermatogenesis deficiencies. The objective is to study the efficacy of hyperbaric therapy in the acute phase in rats with spinal cord injury (SCI) to recover spermatogenesis. Materials and Methods Experimental study approved by the ethics and research committee. Eighteen rats were submitted to T9 spinal cord trauma by a 25 g weight drop using the MASCIS Impactor. They were allocated randomly to the hyperbaric therapy (HBT) and control group. The rats submitted to HBT had 1 hour sessions daily at 2 atmospheres of oxygen for 7 days. Previous works by the authors of this study support the HBT protocol chosen. The control group had supportive treatment. Testicular biopsies were performed by median abdominal incision in all rats on the 1st and 28th day of study. The samples obtained were soaked in hypoosmotic solution to evaluate the concentration of sperm per mL, number of round cells per field, number of infectious cells per field (peroxidase-Endtz test), and sperm viability (HOS test). The data were analyzed using SPSS software v.20, described by mean and standard deviation, and compared using the Student t-test or Mann–Whitney U-test according to the parametricity of the variable. A p-value of < 0.05 was considered significant. Results The mean concentration of sperm per mL did not change in the HBT ( p = 0.41) and control groups ( p = 0.74) over the 28 days of the study. The number of round cells and inflammatory cells per field was significantly greater in both groups on the 28th day. Sperm viability from day 1 to day 28 diminished two times more in the control ( p = 0.001) than in the HBT group ( p = 0.017) and sperm viability was significantly greater on day 28 in the HBT group as compared with the control group (86.67 ± 5.59% vs. 48.75 ± 21.83%) ( p < 0.001). The other variables analyzed did not present a statistically significant difference between the groups. Conclusion The SCI promote spermatogenesis deficiencies that can be partially recovered by the HBT performed in the acute phase of SCI. Sperm viability was two times greater in the HBT group when compared with the control group 28 days after the injury.