title: 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.
authors.affiliation: Department of Urology, Arak University of Medical Sciences, Arak, Iran.
authors.forename: Ali
authors.initials: A
authors.lastname: Cyrus
authors.affiliation: School of Public Health, Shahid Beheshti University of Medical Sciences, Department of Epidemiology, Nikan Health Researchers Institute, Iran and Iran University of Medical Sciences Gastrointestinal and Liver Disease Research Center, Iran.
authors.forename: Ali
authors.initials: A
authors.lastname: Kabir
authors.affiliation: Department of Urology, Arak University of Medical Sciences, Arak, Iran.
authors.forename: Davood
authors.initials: D
authors.lastname: Goodarzi
authors.affiliation: Department of Surgery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Mehrdad
authors.initials: M
authors.lastname: Moghimi
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D000975:Antioxidants / Q000627:therapeutic use*; D001205:Ascorbic Acid / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant; D004311:Double-Blind Method; D006801:Humans; D007248:Infertility, Male / Q000188:drug therapy*; D008297:Male; D010919:Placebos / Q000627:therapeutic use; D015203:Reproducibility of Results; D055101:Semen Analysis; D013091:Spermatogenesis / Q000187:drug effects; D013094:Spermatozoa / Q000187:drug effects*; D016896:Treatment Outcome; D014646:Varicocele / Q000601:surgery*; D055815:Young Adult
chemical_list: D000975:Antioxidants; D010919:Placebos; D001205:Ascorbic Acid