Morphological Effects of Artesunate on the Testicular Histomorphometry and Fertility Indices of Male Wistar Rats

Artesunate is the most widely prescribed artemisinin-based antimalarial in Nigeria and sub-Saharan Africa. While its clinical efficacy against malaria is well established, concerns regarding its potential reproductive toxicity have been raised in the literature, with conflicting results across animal studies regarding its effects on male gonadal histology. Given the widespread and repeated use of artesunate in malaria-endemic Nigeria, a thorough histomorphometric assessment of its effects on testicular structure and fertility potential at therapeutic doses is warranted. This study aims to evaluate testicular histomorphometry and fertility indices in male Wistar rats treated with therapeutic doses of artesunate for three consecutive five-day courses at 28-day intervals. Thirty rats will be randomised into control, single-course, and triple-course treatment groups. Testicular weight, germinal epithelial height, Sertoli cell index, and Johnsen scoring of spermatogenesis will be assessed on haematoxylin and eosin sections. Sperm motility, count, and morphology will be evaluated from cauda epididymal fluid. Serum testosterone and follicle-stimulating hormone levels will be measured. The study anticipates providing definitive histomorphometric evidence on whether repeated therapeutic artesunate use impairs testicular structure and spermatogenesis in a manner clinically relevant to male reproductive health in malaria-endemic Nigeria.

Keywords: artesunate, testicular histomorphometry, spermatogenesis, antimalarial, male reproductive toxicology