The effect of adjuvant vitamin C after varicocele surgery on sperm quality and quantity in infertile men: a double blind placebo controlled clinical trial

Abstract

Varicocele is one of the most common causes of male infertility and spontaneous pregnancy rate after varicocelectomy is only about 30%. The most important seminal antioxidant is vitamin C but recent studies about the effects of vitamin C on spermatogenesis are controversial; therefore, we decided to evaluate its role after varicocelectomy. In a double blind randomized controlled clinical trial, 115 men with infertility and clinical varicocele with abnormal semen analyses were recruited. After surgery, the intervention group received vitamin C (250 mg bid) and the control group received placebo for three months. Mean sperm count, motility, and morphology index of two semen analyses (before and after surgery) were compared between the two groups. Univariate general linear model and stepwise linear regression were used in analysis. The mean age (±SD) of participants was 27.6±5.3 years. Vitamin C group had statistically significant better normal motility (20.8 vs. 12.6, P=0.041) and morphology (23.2 vs. 10.5, P<0.001) than placebo group. Considering the values prior to surgery as covariate, vitamin C was not effective on sperm count (P=0.091); but it improved sperm motility (P=0.016) and morphology (P<0.001) even after excluding the confounding effect of age (P=0.044 and P=0.001, respectively). Vitamin C was also an independent factor in predicting motility and normal morphology after surgery. Ascorbic acid can play a role as adjuvant treatment after varicocelectomy in infertile men.

One‐carbon cycle support rescues sperm damage in experimentally induced varicocoele in rats

“…Considering the prevalence of varicocoele amongst infertile men (21–41%) and its trend to increase by ~10% for each decade of life , effective treatments are welcome. A useful therapeutic approach is the administration of exogenous antioxidants to minimise and/or remove damage caused by excessive oxidative stress . The present study assessed the effect of Condensyl supplementation on sperm parameters, lipid peroxidation and chromatin status in a rat varicocoele model.…”

“…The rate of immature sperm in the control and sham-operated rats grew non-significantly from 2 to 4 months, which is linked to the ageing process. However, the percentage of sperm with persistent histones was significantly (P < 0.05) higher in the VI group [mean (SEM) 9…”

Efficacy of antioxidant therapy on sperm quality measurements after varicocelectomy: A systematic review and meta‐analysis

“…Among the remaining 17 studies, nine studies were excluded for lack of useful data and another two studies because they were identical studies describing the same indicators. Finally, six articles (Azizollahi et al, ; Cyrus, Kabir, Goodarzi, & Moghimi, ; Ener et al, ; Kizilay & Altay, ; Lu, Liu, Li, Yang, & Zhang, ; Nematollahi‐Mahani, Azizollahi, Baneshi, Safari, & Azizollahi, ) comparing sperm outcomes between antioxidant therapy and placebo therapy after varicocelectomy were included in our study (Figure describes the search process in detail). The baseline characteristics of these six studies are summarised in Table .…”

Physiological and Pathological Roles of Free Radicals in Male Reproduction

“…Vitamin C supplementation following surgery resulted in a better motility and morphology. Prior to surgery, vitamin C was not effective on the sperm count, but it improved sperm motility and morphology [160] Vitamin E • 110 asthenozoospermic patients received 300 mg of vitamin E daily over a period of 26 weeks. At the end of the experiment, sperm motility increased, while LPO decreased in the studied population [161] Vitamin C and vitamin E…”