title: Comparison of recombinant human follicle stimulating hormone (rhFSH), human chorionic gonadotropin (HCG) and human menopausal gonadotropin (HMG) on semen parameters after varicocelectomy: a randomized clinical trial.
abstract: BACKGROUND
  The most frequent physical finding in infertile men is varicocele, in which one of the mechanisms that can affect seminal parameters is oxidative stress.
  
  
  OBJECTIVE
  Our study aimed, for the first time, to compare the efficacy of recombinant human follicle-stimulating hormone (rhFSH), human chorionic gonadotropin (HCG) and human menopausal gonadotropin (HMG) on sperm parameters and fertility after varicocelectomy.
  
  
  METHODS
  113 infertile men with varicocele were divided into four groups. Group A received HCG 5000 IU weekly, group B received HMG 75 IU three times a week, group C received rhFSH 75 IU three times a week and group D received no medical treatment after varicocelectomy.
  
  
  RESULTS
  After three months, in group A sperm morphology improved (p=0.007), causing a 32% pregnancy rate. In group B, sperm motility (p=0.023) and morphology (p=0.014) improved, causing a 57% pregnancy rate. In group C, all of the investigated semen parameters increased (p<0.05), causing a 62.5% pregnancy rate. Only rhFSH improved sperm concentrations to >20×10(6) mL (p=0.027). In group D, sperm morphology increased (p=0.038), but other parameters remained unchanged and no pregnancies occurred.
  
  
  CONCLUSIONS
  It can be concluded that drugs can reduce induction time for spermatogenesis and fertility in comparison with varicocelectomy alone. For these purposes, rhFSH is more effective than other drugs.
authors.affiliation: Department of Urology, Hamadan University of Medical Sciences, Hamadan, Iran.
authors.forename: Mohammad Ali
authors.initials: MA
authors.lastname: Amirzargar
authors.affiliation: Department of Obstetrics and Gynecology, Fatemieh Infertility Research Center, Hamadan University of Medical Sciences, Hamadan, Iran.
authors.forename: Mahnaz
authors.initials: M
authors.lastname: Yavangi
authors.affiliation: Urology and Nephrology Research Center, Shahid Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Abbass
authors.initials: A
authors.lastname: Basiri
authors.affiliation: Urology and Nephrology Research Center, Shahid Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Sayyed Mahdi
authors.initials: SM
authors.lastname: Hosseini Moghaddam
authors.affiliation: Department of Urology, Hamadan University of Medical Sciences, Hamadan, Iran.
authors.forename: Hooshang
authors.initials: H
authors.lastname: Babbolhavaeji
authors.affiliation: Urology and Nephrology Research Center, Shahid Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Nasibeh
authors.initials: N
authors.lastname: Amirzargar
authors.affiliation: Urology and Nephrology Research Center, Shahid Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Hossein
authors.initials: H
authors.lastname: Amirzargar
authors.affiliation: Urology and Nephrology Research Center, Shahid Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Leila
authors.initials: L
authors.lastname: Moadabshoar
keywords: HCG; HMG; Male Infertility; Semen Analyses; Varicocele; Varicocelectomy; rhFSH