| خلاصه مقاله | Background: Varicocele is the leading cause of male infertility throughout the world. Various mechanisms have been proposed to explain the testicular dysfunction in varicoceles, including
Increase testicular temperature, hypoxia and increase level of reactive oxygen species (ROS). There are controversy over the effectiveness of surgical treatments, patient selection, and when to administer treatment, particularly in the era of assisted reproductive technology. Therefore finding a strategy to improve sperm parameter of varicocele patients may improve assisted reproductive technology outcomes. The aim of the present study was to assess the effect of ejaculatory abstinence (EA) periods on routine and advanced sperm tests among varicocele patients.
Materials and Methods: This study included 76 ejaculates from 38 men with grade I or II varicocele who provided ejaculates after observing 3 days and 2 hours of abstinence. A standard semen analysis was performed on all samples according to World Health Organization (WHO) protocols. Each specimen was assessed for levels of malondialdehyde (MDA) as an index of ROS, total antioxidant capacity (TAC) and sperm DNA fragmentation (SDF). Statistical analysis was done using SPSS version 23.
Results: The shorter period of EA (2 hours) resulted in statistically significant decreases in semen volume, sperm count and sperm motility in comparison with 3 days of abstinence (P<
0.05). Results also showed no differences in TAC level between groups. Lower levels of SDF and MDA were observed after 2 hours periods of abstinence in compared with 3 days EA (P<
0.05).
Conclusion: Lower seminal ROS obtained after a shorter period of EA could diminish oxidative stress induced SDF in varicocele patients. Despite the significantly lower semen volume,
sperm concentration and lower motility, the significantly higher percentage of spermatozoa with lower SDF in the short period ejaculate, may provide more effective selection
of higher quality spermatozoa. Therefore, use of short period of EA for therapeutic fertilization would be a clinically valuable strategy to improve the DNA quality and subsequently ART outcome. |