RESUMO
Objectives: To explore the impact of surgical correction of varicocele on antioxidant defense system, we assessed spermatozoal reactive oxygen species [ROS] and total antioxidant capacity of seminal plasma from infertile men with varicoceles pre and post varicocelectomy
Patients and Methods: A total of 58 patients with varicocele who presented for evaluation of infertility were studied, the duration of infertility was 12 months. All patients were subjected pre-operatively to seminal fluid analysis, seminal plasma levels of two ROS: malondialdehyde [MDA] and hydrogen peroxide [H2O2] and one ROS radical; nitric oxide [NO] were estimated as well as 4 antioxidants namely; superoxide dismutase [SOD], glutathione perioxidase [GPX], Vitamin E and Vitamin C. Varicocelectomy was done in all patients by the laparoscopic method. Semen analysis and seminal fluid levels of MDA, H2O2, NO, SOD, GPX, Vitamin E and Vitamin C, were measured 3 and 6 months after varicocelectomy
Results: A statisticany significant improvement was noticed in all seminal parameters 3 and 6 months after varicocelectomy. There was also a significant reduction in the level of MDA, H2O2 and NO when comparing with the pre-operative values. A further significant reduction in the three ROS levels took place after 6 months. Three of the four antioxidants tested [SOD, GPX and Vitamin C] showed a significant increase in seminal plasma at 3 and 6 months after varicocelectomy when compared with the pre-operative values. Alternatively, seminal plasma level of Vitamin E showed a significant decrease at 3 and 6 months post-operatively
Conclusion: These results suggest that varicocele is associated with elevated seminal reactive oxygen species, decreased seminal total antioxidant agents and sperm dysfunction. Our data propose that varicocelectomy reduced seminal ROS levels and increased total antioxidant capacity levels. However, the use of antioxidants in infertile men with or without varicocele demands further controlled clinical trials