Could the Effect of Arsenic on the Testis be Reversed after Removing the Insult? A Meta-analysis Study

Arsenic in drinking water has been associated with an increased risk of health concerns. This metalloid is ingested and distributed throughout the body, accumulating in several organs, including the testis. In this organ, arsenic disturbs steroidogenesis and spermatogenesis and affects male fertility. Although testicular impairment induced by arsenic is well documented, it is still controversial whether such disturbance remains days after the removal of arsenic insult. Therefore, we used a meta-analytical approach to evaluate the magnitude of arsenic effects on testicular parameters and verify whether a withdrawal period can mitigate these alterations. The search terms 'testis" and 'arsenic' were used in PubMed/Medline, Scopus, and Web of Science databases. A total of 1,217 articles were obtained from the literature search, and 73 articles were included in this meta-analysis. Our results showed that arsenic negatively affected hormone synthesis and secretion, testicular weight, tubular and intertubular morphometry, and daily sperm production 24 h after ending exposure. Arsenic inhibited antioxidant enzyme activity, culminating in high oxidative metabolite production and apoptosis occurrence. Most of these effects were not observed in the testis between eight and fifty days after arsenic withdrawal, remaining endocrine dysregulation and oxidative metabolite production. Sodium arsenite was the most toxic compound to the testis at subchronic exposure. These findings shed light on the plasticity and regenerative capacity of testicular interstitium and spermatogonial stem cell niche. However, sexual hormone imbalance remained after arsenic removal. This review evidenced the importance of understanding its toxicity's short- and long-term effects on male reproductive competence.