preliminary study: n-acetyl-l-cysteine improves semen quality following varicocelectomy

Background: Surgery is considered the primary treatment for male infertility from clinical varicocele. One of the main events associated with varicocele is excessive production of reactive oxygen species [ROS]. N-acetyl-L-cysteine [NAC], an antioxidant that scavenges free radicals, is considered a supplement to alleviate glutathione [GSH] depletion during oxidative stress. Despite beneficial effects of NAC in other pathological events, there is no report on the effect of NAC in individuals with varicocele. Therefore, the aim of this study is to evaluate the outcome of NAC on semen quality, protamine content, DNA damage, oxidative stress and fertility following varicocelectomy

Materials and Methods: This prospective clinical trial included 35 infertile men with varicocele randomly divided into control [n=20] and NAC [n=15] groups. We assessed semen parameters, protamine content [chromomycin A3 [CMA3]], DNA integrity [terminal deoxynucleotidyltransferase-mediated dUTP nick-end labeling [TUNEL]] and oxidative stress [2', 7'-dichlorodihydrofluorescein-diacetate [DCFH-DA]] before and three months after varicocelectomy

Results: Percentage of abnormal semen parameters, protamine deficiency, DNA fragmentation and oxidative stress were significantly decreased in both groups compared to before surgery. We calculated the percentage of improvement in these parameters compared to before surgery for each group, then compared the results between the groups. Only percentage of protamine deficiency and DNA fragmentation significantly differed between the NAC and control groups

Conclusion: The results of this study, for the first time, revealed that NAC improved chromatin integrity and pregnancy rate when administered as adjunct therapy post-varico-celectomy [Registeration Number: IRCT201508177223N5]

Selection of sperm based on hypo-osmotic swelling may improve ICSI outcome: a preliminary prospective clinical trial

The intra-cytoplasmic sperm injection [ICSI] technique selects sperm according to morphology and motility. However, these parameters cannot predict the chromatin integrity of sperm. Considering the detrimental effects of DNA-damaged sperm on reproductive outcomes, novel sperm selection procedures have been proposed to circumvent the possibility of inseminating DNA-damaged sperm. It has been shown that different potential hypo-osmotic swelling test [HOST] patterns possess the potential to differentiate between sperm that have intact or damaged chromatin. Therefore, for the first time, this preliminary study evaluates the role of HOST as a sperm selection procedure in a clinical setting. In this preliminary prospective clinical trial study, we divided infertile couples diagnosed with male infertility into two groups. In the treatment group [n=39], half of the oocytes were inseminated by sperm selected following density gradient centrifugation [DGC group]. The remaining oocytes from the treatment group were inseminated by sperm chosen according to HOST pattern [c, d or e] following DGC processing [HOST group]. In the control group [n=63], all oocytes were inseminated by sperm chosen after DGC. There was a significantly higher percentage of embryos that had good quality, implantation, and chemical pregnancy rates in the HOST group compared to the DGC group [p