Reversible
effect of testosterone undecanoate injection on spermatogenesis in rats
Xiao-Hong
WEN1, Xing-Hai WANG2, Jian-Sun TONG2,
Zheng-Wei YANG1,
Gui-Yuan ZHANG3
1Morphometric
Research Laboratory, North Sichuan Medical College, Nanchong
637007
2Jiangsu Scientific and Technological Institute
for Family Planning,
Nanjing 210029
3Department of Endocrinology, National Research
Institute
for Family Planning, Beijing 100081, China
Asian
J Androl 2000
Sep;
2: 207-211
Keywords:
spermatogenesis;
stereology; testis; testosterone undecanoate
Abstract
Aim:
To study the effect of testosterone undecanoate (TU) injection on
spermatogenesis in rats. Methods:
Twenty adult SD rats received vehicle or TU (8 mg/kg, 19 mg/kg or
625 mg/kg) injection, im, every 15 days for 60 days, and another 38 animals
received similar treatments for 130 days with half of them undergoing arecovery
phase of 120 days (5 rats for each treatment). At the end of the treatment,
testes were removed and the diameter of the seminiferous tubules and the
number of late elongated spermatids (steps 15-19) per testis were estimated
with stereological methods as a measure of the spermatogenic efficiency.
Results: Low dose
(8 mg/kg) TU treatment virtually had no effect on spermatogenesis. A dose
of 19 mg/kg slightly suppressed spermatogenesis 60 days after treatment,
and severe suppression occurred after another 70 days of dosing. Spermatogenesis
was completely recovered at the end of the recovery phase. Large dose (625
mg/kg) TU treatment did not significantly affect spermatogenesis and was
well tolerated by animals. Conclusion:
TU injection reversibly suppresses spermatogenesis in rats.
1
Introduction
Testosterone
enanthate injection is the only androgen preparation that has been
subjected to multicenter trials on male contraception[1-3]. However
the preparation must be frequently (weekly) administered and there is a
demand for a long-acting
preparation producing stable serum levels[4]. Testosterone undecanoate
(TU) is a longer-acting injectable preparation recently synthesized and
commercially
available in China. It has more favorable pharmacokinetics and pharmacodynamics
than testosterone enanthate and may be a more promising preparation to be used
for male contraception[5-10]. The present study was undertaken
in a rat model to investigate the changes in the diameter of the seminiferous
tubules and the number of late spermatids in the testis (as a measure of
spermatogenesis) at the end of the TU treatment and after a period of recovery
phase; a very large dose of TU (625 mg/kg) was also administered to evaluate
toleration by the animals.
2
Materials
and methods
2.1
Animals and treatment
Adult
SD (Sprague-Dawley) rats (body weight 220-250 g) were provided by the
Experimental Animal Center of Jiangsu Province and housed under a 12-hour
light/dark cycle with free access to food and water. TU, dissolved in
tea seed oil (125 mg/mL), was the product of the Xianju Pharmaceutical
Co., Ltd., Zhejiang, China.
A
pilot study demonstrated that serum T levels (measured by RIA) of rats
prior to and 14 and
27 days after a single TU injection (19 mg/kg) were 5.85, 6.55 and 4.60
nmol/L, respectively. Thus the dose of 19 mg/kg every 15 days was chosen
as the regimen to maintain supraphysiological serum testosterone levels.
The low dosage and the very large dosage were arbitrarily determined.
Sixty
animals were randomly divided into 3 groups of 20 animals each, and were designated
as 60-Day Group, 130-Day Group and 250-Day Group. The numerals are the duration
of treatment; 250 signifies 130 days of treatment followed by 120 days
of rest (without the
treatment). Each group was further divided into 4 subgroups (5 animals
each) of different treatments, designated as control, T8, T19 and T625.
The numerals are the TU doses (mg/kg) used. The controls were injected
physiological saline. Injection was given with a micro-syringe (minimum
scale 10 L). At the
end of treatment (at the end of the rest period in case of 250-Day Group)
one testis was removed from each animal. Testis was immediately weighed
and immersion-fixed in Bouin's solution for 24 h before beingstored in
70% ethanol[11].
2.2
Stereological estimation
2.2.1
Section preparation
Three
systematic testicular blocks and 25 m-thick methacrylate-embedded sections
stained with hematoxylin were prepared from each testis as previously
described[11].
2.2.2
Spermatid number
Sections
were observed using oil lens on a computer monitor and the number of elongated
late spermatids (steps 15-19) per unit volume of testis
or per testis was estimated with the optical dissector stereological tool[11].
Eight counting frames (each with an area of 81 m2) were
superimposed on each field, and a total of 749 frames were measured and
a total of 92 elongated spermatid nuclei counted per animal on the average.
2.2.3
Volume of testicular structures
Test
points (the upper left corners of counting frames) hitting the seminiferous
tubular lumen, seminiferous tubules (including the basement membrane)
or interstitial tissue were counted on the first focusing plane, while
counting the spermatids mentioned above. Then the volume fractions (percentage
volumes) of these components in testis and their absolute volumes were
estimated as previously described[11].
2.2.4
Tubule diameter and length
Sections
were observed using a 4 objective lens on monitor, and the diameter of
the seminiferous tubules and their length per testis were estimated in
the same way as previously used for the diameter and length estimation
of the epididymal tubules[11]. An average of 51 tubules were
sampled and measured per animal.
2.3
Statistics
All
data are shown as meanSEM. The difference between groups was analyzed
with one-way ANOVA (analysis of variance) and significance was set at P<0.05.
Significant difference being tested, all pairwise multiple comparisons were
further
performed in conjunction with the Student-Newman-Keuls method.
3
Results
Nothing
special was noted with the animals during the observation period. Upon
histological examination, it was found that in one animal from the T19
and one from the T625 subgroups of the 250 Day Group, the testicular volume
(0.73-0.84 cm3), the percentage volume of the seminiferous
tubules in testis (17.3%-44.3%) and the tubular diameter (181-186 m)
were much lower than those of the other animals (1.13-1.66 cm3,
65.2%-84.8% and 247-293 m, respectively). Furthermore in these two animals
marked interstitial edema was observed, mainly around the seminiferous
tubules, and only spermatogonia (mostly type A) and Sertoli cells were
present in the seminiferous epithelium. The spermatogenesis of other animals
from the two subgroups
appeared normal. Consequently the data of these two animals were discarded.
3.1
Testicular volume
The
mean testicular volumes of the three control groups were 1.56-1.62 cm3. In
the 60-Day Group, the testicular volumes in T19 and T625 subgroups (83% of
control) were significantly reduced compared to the control and T8 subgroups.
In the 130 Day Group,
the volume in T19 (43% of control) was significantly smaller than each
of the other three subgroups. In the 250 Day Group, the testicular size
in T19 was recovered after a rest period of 120 days and the size in T625
was significantly smaller than that in the control and T8 subgroups. However
the size in T625 of the 250 Day Group was not significantly different
from that in T625 of the 130 Day Group (t-test, P>0.05)
(Figure 1).
Figure
1. Testicular volume, diameter and length of the seminiferous tubules,
and number of late (steps 15-19) elongated spermatids in animals receiving
vehicle (empty) and testosterone undecanoate injection
(i.m. every 15 days) at doses of
8 mg/kg (stippled), 19 mg/kg (striped) and 625 mg/kg (shaded). The symbol
indicates the pair of data being significantly different (P<0.05,
one-way ANOVA in conjunction with the Student-Newman-Keuls method) at
the corresponding time point. day 60 and day 130: 60 and 130 days
after treatment; day 250: 130 days of treatment followed by a rest
period of 120 days without treatment.
3.2
Volumes of testicular structures
The
percentage volume of the seminiferous tubule in the testis was 77.4%-80.5%
in the three control groups, with no significant differences being tested
between control and other treated groups at each time point. The tubular
volumes per testis were 1.22-1.28 cm3 in the three controls.
In the 60 Day Group, the tubular volume (82% of control) in T19 was
significantly smaller than that in the control
or T8 subgroup. In the 130 Day Group, the tubular volume (45% of control)
in T19 was significantly reduced compared to each of the other three groups.
In
the three controls, the percentage volume of the tubular lumen in the testis
was 5.6%-7.1% and the luminal volume per testis was 0.09-0.11 cm3.
In the 130 Day Group, the percentage volume (38% of control) and the
luminal volume (17% of control) in T19 were significantly reduced compared
to each of the other three subgroups.
3.3
Tubular diameter and length
In
the three controls, the tubular diameter and length per testis were
278-299 m and 17.9-21.0 m, respectively. In the 130 Day Group, the tubular
diameter (73% of control) in T19 was significantly smaller compared
to each of the other three
subgroups; the tubular length (83% of control) in T19 was significantly shorter
than that in T625 but not the control (Figures 1 and 2).
3.4
Number of late spermatids
The
number of late spermatids per mm3 of testis was 0.14-0.19 million
in the three controls.
A considerable number of late spermatids could still be seen even in the
most seriously suppressed animals (T19 subgroup of the 130 Day Group),
but the number was greatly reduced with a numerical density (23% of
control) significantly smaller than that in the other three subgroups
(Figure 2).
Figure
2. Micrographs showing testicular structures from animals receiving
vehicle (A) and testosterone undecanoate injection (i.m. every 15 days)
at doses of 625 mg/kg (B) and 19 mg/kg (C) for 130 days, and at the dose
of 19 mg/kg for 130 days
followed by a rest period of 120 days without treatment (D). The width
of each micrograph is 780 m.
The
total number of late spermatids per testis was 22123, 27518
and 29927
million in the three controls of the 60, 130 and 250 Day Groups, respectively.
In the 60 Day Group, TU treatment had a significant influence on the cell
number (P<0.05 with one-way ANOVA) and the numbers in the T19
and T625 were 73% and 78% of the control or T8, respectively (statistically
insignificant for
each
pair of comparison with the Student-Newman-Keuls method). In the
130 Day Group, the number (10% of control) in T19 was significantly
reduced compared to each of the other three subgroups (Figure
1).
4
Discussion
The
present study demonstrated that TU treatment every 15 days at a low dose
(8 mg/kg) virtually did not influence spermatogenesis in rats. TU at 19
mg/kg slightly suppressed
spermatogenesis 60 days after treatment, while severe suppression resulted
after continued treatment for another 70 days. Complete recovery occurred
120 days after cessation of TU treatment. A large dose (625 mg/kg) of
TU did not significantly suppress spermatogenesis and was well tolerated
by animals, which was consistent with previous studies indicating that
large dose of testosterone could maintain or restore spermatogenesis in
hypophysectomized or intact rats[12-13].
As
shown in the current study, a significant number (10% of control) of late
(steps 15-19) spermatids remained within the seminiferous epithelium in
spite of marked suppression
of spermatogenesis after the TU treatment at 19 mg/kg for 130 days. However,
such a degree of suppression might still lead to azoospermia and a possible
explanation is that spermatogenic suppression might be associated with
an impaired release of late spermatids as was observed in men and monkeys[14-15].
After testosterone enanthate treatment (s.c.) for 19-24 weeks, 4 men became
azoospermic, but testicular biopsy showed the presence of late (steps
7-8) spermatids with a numerical density of 10% of the control[14].
In monkeys, 2.8%-9.2% of the total late (steps 13-14) spermatids were
retained within more stages
of the seminiferous epithelium after GnRH antagonist-induced gonadotrophin
withdrawal for 16-25 days[15].
Few
studies have investigated whether spermatogenesis, in terms of germ cell
numbers, would fully recover after drug treatment that induce gonadotropin
withdrawal. Hikim and Swerdloff (1994) reported a complete reversal of late
spermatid number, testicular weight
and tubule diameter 6 weeks after cessation of Nal-Glu-GnRH treatment in
rats[16]. The present study also showed a complete restoration
of spermatogenesis after TU suppression.
References
[1]
Schearer SB, Alvarez-Sanchez F, Anselmo J, Brenner P, Coutinho E, Latham-Faundes
A, et al. Hormonal contraception for men. Int J Androl 1978; (Supplement
2): 680-712.
[2] WHO Task Force on Methods for the Regulation of Male Fertility. Contraceptive efficacy
of testosterone-induced azoospermia in normal men. Lancet 1990; 336:
955-9.
[3] Wu FC, Farley TM, Peregoudov A, Waites GM. Effects of testosterone
enanthate in normal men: experience from a multicenter contraceptive efficacy
study. World Health
Organization Task Force on Methods for the Regulation of Male Fertility. Fertil
Steril 1996; 65: 626-36.
[4] Amory JK, Bremner WJ. Newer agents for hormonal contraception in the
male. Trends Endocrinol Metab 2000; 11: 61-6.
[5] Partsch CJ, Weinbauer GF, Fang R, Nieschlag E. Injectable testosterone
undecanoate has more favourable pharmacokinetics and pharmacodynamics
than testosterone enanthate. Eur J Endocrinol 1995; 132: 514-9.
[6] Zhang GY, Gu YQ, Wang XH, Cui YG, Bremner WJ. A pharmacokinetic study
of injectable testosterone undecanoate in hypogonadal men. J Androl 1998;
19: 761-8.
[7] Behre HM, Abshagen K, Oettel M, Hubler D, Nieschlag E. Intramuscular
injection of testosterone undecanoate for the treatment of male hopogonadism:
phase I studies. Eur J Endocrinol 1999; 140: 414-9.
[8] Nieschlag E, Buchter D, Von Eckardstein S, Abshagen K, Simoni M, Behre
HM. Repeated intramuscular injection of testosterone undecanoate for substitution
therapy in hopogonadal men. Clin Endocrinol (Oxf) 1999; 51: 757-63.
[9] Gao ES, Lin CH, Gui YL, Li LM, He CH. The clinical study on sino-implant
plus testosterone
undecanoate (TU) administered in Chinese men. Reprod Contracept (China)
1999; 19: 158-62.
[10] Zhang GY, Gu YQ, Wang XH, Cui YG, Bremner WJ. A clinical trial of
injectable testosterone
undecanoate as a potential male contraceptive in normal Chinese men. J
Clin Endocrinol Metab 1999; 84: 3642-7.
[11] Wen XH, Yang ZW. Quantitative (stereological) study on the spermatozoal
storage capacity of epididymis in rats and monkeys. Asian J Androl; 2000;
2: 73-7.
[12] Sharpe RM. Regulation of spermatogenesis. In: Knobil E, Neill JD,
eds. The Physiology of Reproduction. Vol. 1. New York: Raven Press, 1994:
p 1363-434.
[13] McLachlan RI, Wreford NG, Meachem SJ, de Kretser DM, Robertson DM.
Effects of testosterone on spermatogenic cell populations in the adult
rat. Biol Reprod 1994; 51: 945-55.
[14] Yang ZW, Wreford NG, Royce P, de Kretser DM, McLachlan RI. Stereological
evaluation of human spermatogenesis after suppression by testosterone
treatment: heterogeneous pattern of spermatogenic impairment. J Clin Endocrinol
Metab 1998; 83: 1284-91.
[15] Yang ZW, Wreford NG, Schlatt S, Weinbauer GF, Nieschlag E, McLachlan
RI. Acute and specific
impairment of spermatogonial development by GnRH antagonist-induced gonadotrophin
withdrawal in the adult macaque (Macaca fascicularis). J Reprod Fertil
1998; 112: 139-47.
[16] Hikim AP, Swerdloff RS. Time course of recovery of spermatogenesis
and Leydig
cell function after cessation of gonadotropin-releasing hormone antagonist
treatment in the adult rat. Endocrinology 1994; 134: 1627-34.
Financially
supported by a 9th five-year National Key Grant of Science and Technology
(Grant number: 969040401), and by Sichuan Committee of Education.
Correspondence to: Prof. Zheng-Wei YANG, Director, Morphometric Research
Laboratory, North Sichuan Medical College, 234 Fujiang Road, Nanchong,
Sichuan 637007, China.
Received
2000-03-14 Accepted 2000-06-29
|