Eurycoma longifolia (Tongkat Ali; TA) is a Malaysian shrub used to treat various
illnesses including male infertility. Considering that TA is also used to improve
male fertility and no report regarding its safety has been published, this study
investigated the effects of a patented, aqueous TA extract on various sperm and
testicular functions. Materials and Methods: This study encompasses two parts (part 1: on spermatozoa; part 2: on TM3-Leydig and TM4-Sertoli cells). Part 1: Semen samples of 27 patients and 13 fertile donors were divided into two groups, washed and swim-up prepared spermatozoa, and incubated with different concentrations of TA (1, 10, 20, 100, 2000 μg/ml) for 1 hour at 37°C. A sample without addition of TA served as control. After incubation with TA, the following parameters were evaluated: viability (Eosin-Nigrosin test), total and progressive motility (CASA), acrosome reaction (triple stain technique), sperm production of reactive oxygen species (ROS; dihydroethidium test; DHE), sperm DNA fragmentation (TUNEL assay) and mitochondrial membrane potential (Δψm) (Depsipher kit). Part 2: TM3-Leydig and TM4-Sertoli cells incubated with different
concentrations of TA (0.4, 0.8, 1.6, 3.125, 6.25, 12.5, 25, 50 μg/ml) and control (without extract) for 48 and 96 hours. After incubation with TA, the following parameters were evaluated: viability (XTT), cell proliferation (protein assay),
testosterone (testosterone ELISA test) and pyruvate (pyruvate assay). Results
Part 1: For washed spermatozoa, significant dose-dependent trends were found
for viability, total motility, acrosome reaction and sperm ROS production.
However, these trends were only significant if the highest concentrations were
included in the calculation. In the swim-up spermatozoa, ROS production of spermatozoa showed a biphasic relationship with its lowest percentage at 10 μg/ml, yet, no significance could be observed (P=0.9505). No influence of TA could be observed for sperm DNA fragmentation nor Δψm. Part 2: The viability rates and protein production of TM3-Leydig and TM4-Sertoli cells at 48-hour exposure to TA showed increases whereas at 96-hour incubation periods viability and protein production declined especially as from concentration 25 μg/ml TA. Similar results could be seen for TM4-Sertoli cells pyruvate production. The testosterone production at 48-hour exposure
marginally increased (P=0.0580) at the highest (50 μg/ml) concentration of TA.
However, at 96-hour exposure to TA the testosterone production significantly
(P=0.0065) increased. It is also apparent that after 96 hours the concentration of
testosterone has increased [12 x 10-4 ng/ml] when compared to 48-hour exposure
[6 x 10-7ng/ml] of Tongkat Ali. Conclusion: Part 1: Results indicate that the Tongkat Ali extract has no deleterious effects on sperm functions at therapeutically used concentrations (<2.5 μg/ml). Part 2: The cytotoxic effect of TA are only presented at higher concentration from 25 μg/ml. TM3-Leydig cells appears to be more resilient than TM4-Sertoli cells in viability and protein production yet at prolonged periods of exposure it is detrimental. Testosterone production only increases after 96 hours exposure to