The use of L-arginine in male reproductive abnormalities: An educational article and expert opinion

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Opinion Article | DOI: https://doi.org/10.31579/2640-1045/178

The use of L-arginine in male reproductive abnormalities: An educational article and expert opinion

Aamir Jalal Al-Mosawi ^*

The National Training and Development Center and Baghdad Medical City Baghdad Iraq

*Corresponding Author: Aamir Jalal Al-Mosawi, The National Training and Development Center and Baghdad Medical City Baghdad Iraq

Citation: Aamir Jalal Al-Mosawi, (2024), Subclinical Hypothyroidism in Adults- to TREAT OR NOT? Endocrinology and disorders; 8(2): DOI 10.31579/2640-1045/178

Copyright: © 2024 Aamir Jalal Al-Mosawi, this is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Received: 18 April 2024 | Accepted: 28 March 2024 | Published: 10 April 2024

Keywords: l-arginine; male reproductive abnormalities; expert opinion

Abstract

Dietary health supplements have been increasingly used in the treatment of a variety of conditions. During the previous decades, L-arginine has been reported to have beneficial effects on male reproductive functions. Arginine is an amino acid that is important for being a precursor for the synthesis of nitric oxide, and playing a role in the regulation of blood pressure. The aim of this paper is to review L-arginine research findings relevant to its use in male reproductive abnormalities.
Conclusion and expert opinion: A variety of agents have been used in the treatment of poor semen quality of unknown etiology (Idiopathic) with a beneficial effect including mesterolone, zinc sulphate, coenzyme Q10, vitamin E, folic acid, pentoxifylline, and L-carnitine. A beneficial effect of arginine on oligospermia has been suggested as early as 1947. There is convincing research evidence suggesting that L-arginine can improve male reproductive abnormalities and can be useful in the treatment of some form’s male infertility and erectile dysfunction. The addition of a safe therapeutic supplement to the already known therapeutic armamentarium is desirable. The current evidence-based opinion suggests that because L-arginine is safe and can be beneficial when used in patients with male reproductive abnormalities, to be aware of such potentially important therapy.

Introduction


The use of health supplements in the treatment of variety of conditions has been increasingly suggested [1-6].
Arginine is an amino acid that is important for being a precursor for the production of nitric oxide, and for playing a role in the regulation of blood pressure, and it has been increasingly used as a health supplement for having beneficial effects in a variety of conditions. L-arginine has been recognized as safe (GRAS-status) when taken in an oral dose of up to 20 g daily [7, 8].
In 1886, Ernst Schulze (Figure-1A) and Ernst Steiger reported the isolation of arginine from yellow lupin seedlings and they called it arginine after “argyrols”, a Greek word means silver, because of the silver-white color of arginine nitrate crystals [9]. In 1897, Ernst Schulze and Ernst Winterstein (Figure-1B) clarified the structure of arginine, and in 1899, they synthesized it from ornithine and cyanamide [10, 11].
A beneficial effect of arginine on oligospermia has been suggested as early as 1947 [12, 13, 14]. During the 1950s and 1960s, several authors including Giarola and Ballerio in 1959, and Pazzaglia and Poggio in 1965 reported the use of arginine in treatment of seminal deficiency [14, 15]. In 1967; Bernard reported the treatment of oligo-asthenospermia with arginine [16]. In 1975, Keller and Polakoski reported that L-arginine can stimulate human sperm motility in vitro [17].
In 1979, Papp et al reported a study which included 40 patients who had normal semen count, oligospermia or azoospermia. Low arginine content was found in patients with oligospermia and azoospermia, and was attributed to higher arginase activity and to higher conversion of arginine to Guanidinoacetic acid [18].
In 1993, Méndez and Hernández emphasized that L-arginine is the precursor of the polyamine’s putrescine, spermidine and spermine which are important in the initiation of the sperm motility processes [19].
In 1994, Scibona et al reported 40 infertile male patients who had a spermatozoa count of more than 20 million/ milliliter (Normal count more than 15 million sperm per milliliter or more than 39 million sperm per ejaculate) , but a reduced sperm motility that was not related to infection or to immune disorders. The patients were treated with oral L-arginine (80 ml of 10%) daily for six months. Treatment was associated with improved sperm motility without any side-effects [20].
In 1995, Aydin and colleagues reported the treatment of 15 patients who had oligospermia and asthenospermia with L-arginine for at least 12 weeks, and three pregnancies were achieved [21].
In 1999, Chen et al reported a placebo-controlled study which included fifty patients with organic erectile dysfunction. 29 patients received oral L-arginine, 5 grams daily, and 21 patients received placebo. Nine (31%) of the patients who received L-arginine, and two of 17 patients who received placebo experienced marked subjective improvement in their sexual function. The beneficial effect of L-arginine was attributed to improved nitric oxide production [22].
In 2022, Menafra et al reported a placebo-controlled study which included 98 patients who had erectile dysfunction attributed to vasculogenic causes. 51 patients received oral L-arginine, 6 grams daily for three months, and 47 patients received placebo. Treatment with L-arginine was associated with marked improvement in erectile dysfunction [23].
Male reproductive abnormalities with poor semen quality (Count and motility) have some times been attributed to epididymo-prostato-vesiculitis which can be recognized generally by finding 5 or more pus cells (White blood cells) per high power field in the semen. Epididymo-prostato-vesiculitis associated with associated with poor semen quality is generally treated with antibiotics such as minocycline and norfloxacin [24, 25, 26].
A variety of agents have been used in the treatment of poor semen quality of unknown etiology (Idiopathic) with a beneficial effect, including mesterolone, zinc sulphate, coenzyme Q10, vitamin E, folic acid, pentoxifylline, and L-carnitine [27-33].

Conclusion and expert opinion

The addition of a safe therapeutic supplement to the already known therapeutic armamentarium is desirable. The current evidence-based opinion suggests that because L-arginine is safe and can be beneficial when used in patients with male reproductive abnormalities, it is important for physicians treating patients with male reproductive abnormalities to be aware of such potentially important therapy.
Acknowledgement
The author has the sketches included in this paper.
Conflict of interest: None.

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My experience publishing in Psychology and Mental Health Care was exceptional. The peer review process was rigorous and constructive, with reviewers providing valuable insights that helped enhance the quality of our work. The editorial team was highly supportive and responsive, making the submission process smooth and efficient. The journal's commitment to high standards and academic rigor makes it a respected platform for quality research. I am grateful for the opportunity to publish in such a reputable journal.

Sonila Qirko

My experience publishing in International Journal of Clinical Case Reports and Reviews was exceptional. I Come forth to Provide a Testimonial Covering the Peer Review Process and the editorial office for the Professional and Impartial Evaluation of the Manuscript.

Luiz Sellmann

I would like to offer my testimony in the support. I have received through the peer review process and support the editorial office where they are to support young authors like me, encourage them to publish their work in your esteemed journals, and globalize and share knowledge globally. I really appreciate your journal, peer review, and editorial office.

Zhao Jia

Dear Agrippa Hilda- Editorial Coordinator of Journal of Neuroscience and Neurological Surgery, "The peer review process was very quick and of high quality, which can also be seen in the articles in the journal. The collaboration with the editorial office was very good."

Thomas Urban

I would like to express my sincere gratitude for the support and efficiency provided by the editorial office throughout the publication process of my article, “Delayed Vulvar Metastases from Rectal Carcinoma: A Case Report.” I greatly appreciate the assistance and guidance I received from your team, which made the entire process smooth and efficient. The peer review process was thorough and constructive, contributing to the overall quality of the final article. I am very grateful for the high level of professionalism and commitment shown by the editorial staff, and I look forward to maintaining a long-term collaboration with the International Journal of Clinical Case Reports and Reviews.

Cristina Berriozabal

To Dear Erin Aust, I would like to express my heartfelt appreciation for the opportunity to have my work published in this esteemed journal. The entire publication process was smooth and well-organized, and I am extremely satisfied with the final result. The Editorial Team demonstrated the utmost professionalism, providing prompt and insightful feedback throughout the review process. Their clear communication and constructive suggestions were invaluable in enhancing my manuscript, and their meticulous attention to detail and dedication to quality are truly commendable. Additionally, the support from the Editorial Office was exceptional. From the initial submission to the final publication, I was guided through every step of the process with great care and professionalism. The team's responsiveness and assistance made the entire experience both easy and stress-free. I am also deeply impressed by the quality and reputation of the journal. It is an honor to have my research featured in such a respected publication, and I am confident that it will make a meaningful contribution to the field.

Dr Tewodros Kassahun Tarekegn

"I am grateful for the opportunity of contributing to [International Journal of Clinical Case Reports and Reviews] and for the rigorous review process that enhances the quality of research published in your esteemed journal. I sincerely appreciate the time and effort of your team who have dedicatedly helped me in improvising changes and modifying my manuscript. The insightful comments and constructive feedback provided have been invaluable in refining and strengthening my work".

Dr Shweta Tiwari

I thank the ‘Journal of Clinical Research and Reports’ for accepting this article for publication. This is a rigorously peer reviewed journal which is on all major global scientific data bases. I note the review process was prompt, thorough and professionally critical. It gave us an insight into a number of important scientific/statistical issues. The review prompted us to review the relevant literature again and look at the limitations of the study. The peer reviewers were open, clear in the instructions and the editorial team was very prompt in their communication. This journal certainly publishes quality research articles. I would recommend the journal for any future publications.

Dr Farooq Wandroo

Dear Jessica Magne, with gratitude for the joint work. Fast process of receiving and processing the submitted scientific materials in “Clinical Cardiology and Cardiovascular Interventions”. High level of competence of the editors with clear and correct recommendations and ideas for enriching the article.

Dr Anyuta Ivanova

We found the peer review process quick and positive in its input. The support from the editorial officer has been very agile, always with the intention of improving the article and taking into account our subsequent corrections.

Dr David Vinyes

My article, titled 'No Way Out of the Smartphone Epidemic Without Considering the Insights of Brain Research,' has been republished in the International Journal of Clinical Case Reports and Reviews. The review process was seamless and professional, with the editors being both friendly and supportive. I am deeply grateful for their efforts.

Gertraud Teuchert-Noodt

To Dear Erin Aust – Editorial Coordinator of Journal of General Medicine and Clinical Practice! I declare that I am absolutely satisfied with your work carried out with great competence in following the manuscript during the various stages from its receipt, during the revision process to the final acceptance for publication. Thank Prof. Elvira Farina

Dr Elvira Farina

Dear Jessica, and the super professional team of the ‘Clinical Cardiology and Cardiovascular Interventions’ I am sincerely grateful to the coordinated work of the journal team for the no problem with the submission of my manuscript: “Cardiometabolic Disorders in A Pregnant Woman with Severe Preeclampsia on the Background of Morbid Obesity (Case Report).” The review process by 5 experts was fast, and the comments were professional, which made it more specific and academic, and the process of publication and presentation of the article was excellent. I recommend that my colleagues publish articles in this journal, and I am interested in further scientific cooperation. Sincerely and best wishes, Dr. Oleg Golyanovskiy.

Dr Oleg Golyanovski

Dear Ashley Rosa, Editorial Coordinator of the journal - Psychology and Mental Health Care. " The process of obtaining publication of my article in the Psychology and Mental Health Journal was positive in all areas. The peer review process resulted in a number of valuable comments, the editorial process was collaborative and timely, and the quality of this journal has been quickly noticed, resulting in alternative journals contacting me to publish with them." Warm regards, Susan Anne Smith, PhD. Australian Breastfeeding Association.

Dr Susan Anne Smith

Clearly Auctoresonline and particularly Psychology and Mental Health Care Journal is dedicated to improving health care services for individuals and populations. The editorial boards' ability to efficiently recognize and share the global importance of health literacy with a variety of stakeholders. Auctoresonline publishing platform can be used to facilitate of optimal client-based services and should be added to health care professionals' repertoire of evidence-based health care resources.

Virginia E. Koenig

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