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Purpose
In this pilot study, the authors compared the effects of antioxidant co‐supplementation therapy and methylcobalamin therapy in patients with impaired semen quality.
Methods
Eighty‐four subjects who visited male infertility clinics and showed abnormal semen test results were randomly subjected to one of the two therapies: antioxidant co‐supplementation therapy with vitamin C, vitamin E, coenzyme Q10, and flaxseed oil or methylcobalamin therapy. The oxidation–reduction potential (ORP) and 8‐hydroxy‐2′‐deoxyguanosine levels were used as indicators of oxidative stress levels in semen. Semen analysis was also performed.
Results
The authors obtained results from 67 patients who had completed 3 months of treatment. Neither antioxidant co‐supplementation therapy nor methylcobalamin therapy changed the semen parameters significantly (except for the sperm concentration, which was increased by the latter therapy). When the pre‐treatment ORP value in semen was higher than the cutoff value, both therapies significantly increased the sperm concentration. The 8‐hydroxy‐2′‐deoxyguanosine level did not yield any meaningful predictive value with regard to increased sperm concentrations.
Conclusions
Both antioxidant co‐supplementation therapy and methylcobalamin therapy increased the sperm concentration in patients with impaired semen quality when the basal ORP levels in their semen were elevated.
by tumours did significantly correlate with spermatogenesis (28.3% with sperm vs. 48.4% when no sperm found, p¼0.05).CONCLUSIONS: Spermatogeneis is present in the majority of testes affected by germ cell tumours (70%), and it does not appear to be related to any tumour pathology, apart from percentage tumour volume. Sperm extraction at the time of orchidectomy is a sensible approach, as testis specimens, destined for the pathology lab, would otherwise be a waste of functionally viable tissue. Given that spermatogenesis was focal in 38%, sperm retrieval is best performed with a microTESE (onco microTESE) to allow identification of these small foci. In our own experience, we have found sperm in 60% of patients with testicular tumour and azoospermia, at first presentation, using this technique. A change in focus to identify the azoospermic patient, prior to orchidecotmy, is vital to allow such an approach to be adopted.
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