Abstract
OBJECTIVE: This study emphasizes the role of oxidative stress in the pathogenesis of male infertility-including varicocele-and supports the utility of antioxidant supplementation. The aim of our study is to evaluate the effectiveness of multiantioxidant therapy in improving semen quality, reducing the DNA fragmentation index, and increasing pregnancy rates in oligoasthenozoospermic (OA) patients with different grades of varicocele. METHODS: We conducted a prospective study of infertile men with OA and varying grades of varicocele. Serum and semen samples were collected at baseline and after 6 months of treatment from subjects with varicocele grades 0, 1, 2, and 3. Sperm DNA damage, reproductive hormones, and pregnancy rates were evaluated. RESULTS: Significant differences in mean sperm count, total sperm count, sperm motility, and normal sperm morphology were observed among groups G1, G2, G3, and G4 (p<0.0001). Sperm DNA integrity improved significantly in patients with varicocele after oral antioxidant therapy. Pregnancy achieved by intrauterine insemination was observed in 11%, 9%, 1%, and 0.7% of couples in groups G1, G2, G3, and G4, respectively. Additionally, spontaneous pregnancy occurred in 6% and 3% of couples with varicocele grade 0 and grade 1, respectively, after multiantioxidant supplementation. No significant pregnancy rate was observed in groups G3 and G4. CONCLUSION: Multiantioxidant therapy produced marked therapeutic benefits in patients with grade 0 and grade 1 varicocele and served as a useful adjuvant in managing varicocele-related infertility.