Melatonin therapy adds extra benefit to varicecelectomy in terms of sperm parameters, hormonal profile and total antioxidant capacity: A placebo-controlled, double-blind trial

Abstract

In this study, we aimed at investigating the impact of melatonin supplementation on semen parameters, hormonal profile and total antioxidant capacity after varicocelectomy. Infertile male patients who were diagnosed with varicocele and underwent subinguinal varicocelectomy were included in the study. After performing subinguinal varicocelectomy, the patients were randomised into two groups: 27 receiving melatonin for 3 months and 27 as the placebo-controlled group receiving placebo for 3 months. The pre-operative parameters of semen analyses, hormonal profile and seminal oxidative stress status of both groups were compared with those of post-operative parameters. There were statistically significant improvements in post-operative parameters of semen analyses (sperm concentration, motility and proportions of normally formed spermatozoa), peripheral blood inhibin B and total antioxidant capacity in melatonin group compared with placebo group. In conclusion, melatonin therapy adds extra benefit to varicecelectomy in terms of sperm parameters, peripheral blood inhibin B and total antioxidant capacity; however, further studies including large number of samples are needed to make a proper decision on melatonin supplementation after varicocelectomy.

The Importance of Oxidative Stress in Determining the Functionality of Mammalian Spermatozoa: A Two-Edged Sword

“…This condition is also known to be associated with a loss of sperm function and DNA integrity as a consequence of oxidative stress [100,101]. Surgical ligation of the left internal spermatic vein to correct the varicosity has been shown to reduce oxidative stress parameters and to improve sperm quality and the concomitant administration of antioxidants has been shown to facilitate this process [102,103]. As we enter an era of elevated ambient temperatures associated with global climate change, we might anticipate an increased incidence of male infertility, as well as an elevated risk of a paternally-induced mutations in the offspring, as a consequence of oxidative DNA damage to the spermatozoa.…”

Varicocoele and oxidative stress: New perspectives from animal and human studies

“…Overall, a decrease in TAC and non‐enzymatic antioxidants was observed when compared to non‐VCL controls in both animal and human studies. Other studies conducted in VCL patients 38‐41 and in animal models of VCL 32,33,42,43 have monitored oxidative damage on some organic components of testicular tissues and spermatozoa. Parameters measured included the level of membrane lipid peroxidation via malondialdehyde (MDA) measurement or/and 4‐hydroxynonenal‐modified proteins (4‐HNE).…”

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 .…”