O-3: Does Antioxidant Therapy Adds any Benefit in Improvement of Sperm Parameters to Standard Inguinal Varicocelectomy? A Randomize Case-Control Study

Background: Varicocele occurs in approximately 15 to 20% of the general male population and it is the most common cause of poor semen production and decreased semen quality. Clinical studies have show that varicocele surgery can improve semen quality. The aim of this study was to evaluate if antioxidant therapy adds any extra benefit to standard inguinal varicocelectomy in improvement of sperm parameters. Materials and Methods: We prospectively evaluated changes in sperm parameters in patients with varicocele before and after varicocelectomy . 100 men with varicocele were enrolled in this study and divided into 2 groups. Fifty men underwent inguinal varicocelectomy and second group underwent varicoceletomy and received L- carnitine 250 m 3 times / day for 6 months. World Health Organization semen analysis was assessed, before, 3 and 6 months post surgery. Results: There was 50 patients with mean age of 27.57 (18-41y) in surgery group and 50 patients in surgery plus drug group with mean age of 26.69 (18-42). 64.6% of surgery only group and 615% of surgery plus drug group surgery were married. Mean sperm count in surgery group before and three and six months after surgery was 46,000,000 ,96,947,000 and 150,444,000 and in surgery drug group 120, 235, 300, 122, 177, 600 and 146, 333, 300. There was not any statistically significant difference between two groups in terms of sperm count 3 and 6 months after surgery. Motility a ,b and normal morphology was compared between two groups that there was not any sign statistically significant difference except the normal morphology three months after surgery ,that was higher in surgery group (21.48 vs. 12.11% p value 0.04). Mean of motility a,b in surgery group was (6.83, 24.5, 3.688, 6.88 and 4.87, 31.77%). Presurgery and 3,6 months after surgery and in surgery drug group was 3.68, 20.43 and 6.28, 29.70 and 8.56, 31.63%. Normal morphology in surgery group was 23.82, 21.35, 22.48% and in surgery drug group was 16.41, 12.11, 21.66%. Within surgery group there was statistically significant improvement in sperm count before ,3 and 6 months after surgery (p value = 0.00, 0.01, 0.03) but in surgery plus drug group improvement was significant only between 3 and 6 months after surgery (p value = 0.15, 0.015 , 0.02). In terms of motility and morphology in surgery group there was significant improvement in morphology 3 and 6 months after surgery and in surgery drug group the only significant change was in motility a,b before and 3 months after surgery. Conclusion: These results show that varicocelectomy improves semen parameters but adding antioxidant therapy to this procedure doesn’t add any extra benefit in terms of improving semen parameters quality.