The use of pentoxifylline in male reproduction abnormalities

Pentoxifylline a derivative of methylxanthine and nonspecific inhibitor of the phosphodiesterase with vasodilatory properties and rheological properties on blood that made it useful in the treatment of intermittent claudication. Pentoxifylline also has an immunomodulatory effect which inhibits on the production inflammatory cytokines including tumor necrosis factor-alpha. The aim of this paper is to review the uses of pentoxifylline in male reproduction abnormalities. The available research evidence suggests that the addition of pentoxifylline to the traditional treatment of erectile dysfunction can be helpful, it also beneficial in the treatment of oligo-asthenozoospermia, possibly through stimulation of sperm motility by increasing the intracellular levels of cAMP.

which included males with mild to moderate penile vascular insuffi ciency causing impotence whom were treated with pentoxifylline 400mg twice daily for 12 weeks. Pentoxifylline treatment regularly increased the penile-brachial pressure index frequently into the normal range, in comparison with patients who received placebo. In 9 of 12 patients, pentoxifylline treatment was associated with reestablishment of coital function [2]. Peşkircioğlu (1996) reported a study which included 36 patients with borderline arterial disease diagnosed with penile duplex ultrasonography. Twenty patients (Aged 40-66 years, mean age 54 years) were treated with oral 400 mg three times daily for 2 months. Sixteen patients (34-65, mean age 54 years) received a placebo. Pentoxifylline treatment increased peak systolic velocities on penile duplex ultrasonography in 12 of the 20 , and the mean change in peak systolic velocities caused by pentoxifylline treatment (6.25 cm/s) was considerably higher than the observed in the control patients (0.38 cm/s).
Seven patients treated by pentoxifylline had successful coitus.
Treatment was not associated with side effects [3]. Ozdal, et al. (2008) reported a study which included 68 patients with various degrees and types of vasculogenic erectile dysfunction who were treated initially with oral sildenafi l (minimum two 50-mg tablets/week), 60 minutes before sexual intercourse for four weeks. Thereafter, pentoxifylline 400 mg three times daily was to the treatment for the next four weeks period. The mean international index of erectile function score was higher after sildenafi l treatment than before treatment score. The international index of erection function score of the patients was higher after the combination treatment compared to pre-treatment score. The increase in international index of erectile function score was 5.62+/-2.08 with sildenafi l treatment, but the score increased 9.51+/-3.77 with the combination therapy. (P<0.001). Ozdal et al suggested the use of sildenafi l citrate and pentoxifylline combined therapy in the treatment of patients with vasculogenic erectile dysfunction [4]. Kumar, et al. (2015) reported a study which included 237 patients having erectile dysfunction whom were treated with tadalafi l or tadalafi l + pentoxifylline for 8 weeks. 78.6% of the patients treated with tadalafi l reported improvement. 86.6% of the patients treated with tadalafi l + pentoxifylline reported improvement. There was no signifi cant difference in between the two groups with regards to occurrence of side effects [5].
Aparicio and colleagues (1980) reported a study which included 15 infertile men (aged 22 to 44 years) with Abstract Pentoxifylline a derivative of methylxanthine and nonspecifi c inhibitor of the phosphodiesterase with vasodilatory properties and rheological properties on blood that made it useful in the treatment of intermittent claudication. Pentoxifylline also has an immunomodulatory effect which inhibits infl ammatory cytokines including tumor necrosis factor-alpha. The aim of this paper is to review the uses of pentoxifylline in male reproduction abnormalities.

Short Communication
The pentoxifylline 400 mg twice daily for six months, 127 received placebo. Treatment was associated with marked increase in sperm count, sperm motility, and sperm with normal morphology, while the controlled patients experience a subtle decrease in these parameters [11]. Azgomi, et al. (2018) reported a study which include 100 males with infertility of unknown cause whom were treated with either pentoxifylline 800 mg/daily or Withania somnifera herbal capsules (5g/daily) for 90 days. Pentoxifylline elevated mean semen volume (16.46%), progressive movement (25.97%) and its use was associated with a sperm morphology (13.28%). Withania somnifera also increased mean sperm count (12.5%) and progressive motility (21.42%) and improved sperm morphology (25.56%) [12].

Conclusion
The available research evidence suggests that the addition