comparison of recombinant human follicle stimulating hormone (rhfsh), human chorionic gonadotropin (hcg) and human menopausal gonadotropin (hmg) on semen parameters after varicocelectomy: a randomized clinical trial

background: the most frequent physical finding in infertile men is varicocele, in which one of the mechanisms that can affect seminal parameters is oxidative stress. objective: our study aimed, for the first time, to compare the efficacy of recombinant human follicle-stimulating hormone (rhfsh), human chorionic gonadotropin (hcg) and human menopausal gonadotropin (hmg) on sperm parameters and fertility after varicocelectomy. materials and methods: 113 infertile men with varicocele were divided into four groups. group a received hcg 5000 iu weekly, group b received hmg 75 iu three times a week, group c received rhfsh 75 iu three times a week and group d received no medical treatment after varicocelectomy. results: after three months, in group a sperm morphology improved (p=0.007), causing a 32% pregnancy rate. in group b, sperm motility (p=0.023) and morphology (p=0.014) improved, causing a 57% pregnancy rate. in group c, all of the investigated semen parameters increased (p<0.05), causing a 62.5% pregnancy rate. only rhfsh improved sperm concentrations to >20×106 ml (p=0.027). in group d, sperm morphology increased (p=0.038), but other parameters remained unchanged and no pregnancies occurred. conclusion: it can be concluded that drugs can reduce induction time for spermatogenesis and fertility in comparison with varicocelectomy alone. for these purposes, rhfsh is more effective than other drugs.