title: Escin improves sperm quality in male patients with varicocele-associated infertility.
abstract: OBJECTIVE
  To evaluate the efficacy of escin to improve sperm quality in Chinese male patients with varicocele-associated infertility.
  
  
  METHODS
  This study included 219 male patients with varicocele-associated infertility. These patients were randomly assigned into three groups: the control, the surgery and the escin group. 106 patients, with a mean age of 30 years old and a mean period of infertility of 5.0 years, were recruited in the escin group and a daily dose of 60mg (30mg every 12h) of escin was administered orally during an uninterrupted period of 2 months. The diameter of spermatic vein was also measured using color Doppler ultrasonography before and after treatment in the escin group. Patients in all groups took composite medicines favorable for sperm quality and semen were obtained and analyzed before and after treatment.
  
  
  RESULTS
  In response to treatment, the improvement rates in sperm density in the control, the surgery and the escin group, were 38.5%, 68.8%, and 57.5%, respectively. The differences in the surgery and the escin groups were significant compared to that in the control group (68.8% or 57.5% vs. 38.5%, P<0.05). The improvement rates in sperm motility in the control, the surgery and the escin group were 46.2%, 77.1%, and 55.7%, respectively. Significant difference was only observed between the surgery and the control group (77.1% vs. 46.2%, P<0.05). In the escin group, when severity of varicocele was classified to mild, moderate or severe degree according to the diameter of the spermatic vein, the improvement rates in disease severity were higher in the mild (41.7% vs. 20.0%, P<0.05) and moderate severity subgroups (64.4% vs. 20.0%, P<0.05) when compared to that in the severe subgroup (20.0%). The improvement rate in disease severity was also higher in the moderate subgroup when compared to that in the mild subgroup (64.4% vs. 41.7%, P<0.05). During the period of treatment, only very low frequencies of mild adverse effects were observed, most of which resolved without further symptomatic drug therapy after advising the patients to take escin after meal. Escin has little effect on vital signs, blood counts, liver or kidney function.
  
  
  CONCLUSIONS
  Escin is a safe and effective drug to improve sperm quality in Chinese male patients with varicocele-associated infertility.
authors.affiliation: Department of Internal Medicine, University of Missouri, Columbia, MO 65212, USA. fangy@health.missouri.edu
authors.forename: Yujiang
authors.initials: Y
authors.lastname: Fang
authors.forename: Lei
authors.initials: L
authors.lastname: Zhao
authors.forename: Feng
authors.initials: F
authors.lastname: Yan
authors.forename: Xiaoyan
authors.initials: X
authors.lastname: Xia
authors.forename: Donghui
authors.initials: D
authors.lastname: Xu
authors.forename: Xijun
authors.initials: X
authors.lastname: Cui
mesh_terms: D000328:Adult; D031319:Aesculus / Q000737:chemistry*; D002317:Cardiovascular Agents / Q000494:pharmacology / Q000627:therapeutic use*; D004928:Escin / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D007248:Infertility, Male / Q000150:complications / Q000188:drug therapy* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D008517:Phytotherapy; D010936:Plant Extracts / Q000494:pharmacology / Q000627:therapeutic use*; D012639:Seeds; D012720:Severity of Illness Index; D013076:Sperm Count; D013081:Sperm Motility / Q000187:drug effects; D013094:Spermatozoa / Q000187:drug effects*; D014646:Varicocele / Q000150:complications / Q000188:drug therapy* / Q000601:surgery; D055815:Young Adult
chemical_list: D002317:Cardiovascular Agents; D010936:Plant Extracts; D004928:Escin