Document Type : Original Article
Department of Biology, Science and Research Branch, Islamic Azad University, Tehran, Iran
Department of Reproductive Biotechnology, Reproductive Biomedicine Research Center, Royan Institute for Biotechnology, ACECR, Isfahan, Iran
Isfahan Fertility and Infertility Centre, Isfahan, Iran
Background: One of the important factor associated with male infertility is high production of reactive oxygen species
(ROS). The main function of Nuclear factor erythroid 2-related factor 2 (NRF 2) is to activate the cellular antioxidant
response by inducing the transcription of a wide array of genes that can combat the harmful effects of factors
such as oxidative stress. The purpose of this study was to evaluate the effect of N-acetyl-L-cysteine (NAC), as an
antioxidant drug, on NRF 2 Gene Expression in Asthenoteratozoospermia Men.
Materials and Methods: In this randomized, blinded clinical trial study, included 50 infertile men with asthenoteratozoospermia,
who received NAC (600 mg, three times daily). Sperm parameters analyzed according to the world health organization
(WHO; 2010). Sperm DNA fragmentation, relative NRF 2 expression, and seminal plasma level of antioxidant enzymes
were measured by TUNEL assay, reverse transcription polymerase chain reaction (RT-PCR) and ELISA test, respectively.
Results: After NAC treatment, findings showed a significant increase in sperm concentration and motility compared
to pre-treatment status, whereas the percentage of abnormal morphology and DNA fragmentation was significantly
decreased (p <0.05). A significant improvement in expression of NRF 2 gene and antioxidant enzyme levels were observed
compared to pre-treatment by NAC (p <0.05). Significant correlations were observed between NRF 2 mRNA
expression level, specific sperm parameters and level of antioxidant enzymes (p <0.05).
Conclusion: The results demonstrated that NAC oral supplementation protected against oxidative stress by enhancing
NRF 2 expression. This could improve semen parameters quality parameters in asthenoteratozoospermia men (Registration