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Effects of nonoxynol-9 (N-9) on sperm functions: systematic review and meta-analysis
Murong Xu1,2, Mingpeng Zhao1, Raymond Hang Wun Li3
1Assisted Reproductive Technology Unit, Department of Obstetrics and Gynaecology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
Objective:
To summarize the currently available phase I and II clinical trials of the effects of nonoxynol-9 (N-9) on human sperm structure and functions.
Methods:
A systematic review and meta-analysis aiming to evaluate the spermicidal activity of N-9 on motility, was conducted in PubMed, EMBASE, and Cochrane databases by 10 March 2021. The counted numbers of progressive motile (PR) sperm in cervical mucus and the vanguard sperm penetration distances were analyzed. Other effects on sperm structures and physiological activities were reviewed as well.
Results:
In the pooled results, percentages or counted numbers of PR sperm decreased after the treatment of N-9. Vanguard sperm penetration distance was shortened in treated groups. N-9 has been confirmed to damage the structures of sperm, as well as other organelles like acrosome and mitochondria. The physiological activities such as generation of reactive oxygen species, superoxide dismutase activity, acrosin activity, and hemizona binding were all inhibited in the reviewed studies.
Conclusions:
N-9 has several impacts on sperm owing to its potency in reducing sperm motility and cervical mucus penetration, as well as other functional competencies.
Lay Summary:
Nonoxynol-9 (N-9) has been used worldwide as a spermicide to kill sperm for more than 60 years but can cause side effects including vaginal irritation and can increase the rate of contraceptive failure. A detailed analysis of published literature aiming to evaluate the spermicidal activity of N-9 on sperm was carried out. In the pooled results, N-9 reduced the number of active sperm and the distance they traveled. It also caused damage to the structures of sperm and to the way the sperm acted and interacted with the egg. In conclusion, N-9 impacts on sperm in a number of ways that lead to sperm death and dysfunction.
Insights
Nonoxynol-9 (N-9) significantly reduces sperm motility and penetration ability. This spermicide damages sperm structure and function, leading to reduced fertility.
Area of Science:
- Reproductive Biology
- Pharmacology
Background:
- Nonoxynol-9 (N-9) is a widely used spermicide with a long history of application.
- Concerns exist regarding N-9's potential side effects and contraceptive efficacy.
Purpose of the Study:
- To systematically review and analyze available clinical trial data on N-9's effects on human sperm.
- To evaluate the spermicidal activity and impact of N-9 on sperm structure and function.
Main Methods:
- A systematic review and meta-analysis of Phase I and II clinical trials.
- Searches were conducted in PubMed, EMBASE, and Cochrane databases up to March 10, 2021.
- Analysis included progressive motile sperm counts and sperm penetration distances.
Main Results:
- N-9 significantly decreased the number and motility of progressive sperm.
- Sperm penetration distance into cervical mucus was reduced.
- N-9 was confirmed to damage sperm structures, including the acrosome and mitochondria.
- Key sperm physiological activities, such as reactive oxygen species generation and acrosin activity, were inhibited.
Conclusions:
- Nonoxynol-9 exhibits potent spermicidal activity, impacting sperm motility and penetration.
- N-9 causes structural damage and inhibits functional competencies of sperm.
- The findings underscore N-9's multifaceted effects leading to sperm dysfunction and death.
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