Changes in seminal antioxidant defenses in Iraqi patients with unilateral and bilateral varicocele

Abstract

Background : The exact pathogenic mechanism by which varicoceles cause impaired testicular function remains poorly understood . One of the possible mechanisms is the generation of seminal oxidative stress. In addition, the impact of bilateral varicocele on spermatogenesis is still poorly studied . Aims : To study the changes in seminal antioxidant defenses in relation to unilateral and bilateral varicocele, and to correlate them with changes in sperm concentration and total motility. Patients and methods : A prospective, randomized, controlled study , whereby 60 semen samples were collected and analyzed. Twenty samples were from healthy subjects , having no varicocele ( control group ), 20 samples from patients with unilateral varicocele and 20 samples from patients with bilateral varicocele . For each semen sample, measurement of the seminal concentration of the antioxidants ( Albumin, Glutathione peroxidase and Superoxide dismutase ) was done and the seminal concentration of the oxidative stress marker, Malondialdehyde. In addition sperm concentration and total motility were also estimated. Comparison of the results in the 3 groups was done . Results : Measurement of semen parameters revealed a drop in the mean value of the 3 antioxidants and an increase in the mean value of Malondialdehyde, which was statistically significant in the 2 varicocele groups in comparison with control, and in bilateral varicocele in comparison with unilateral varicocele . Another drop was in the mean sperm concentration and mean percentage of sperm total motility, which was statistically significant in the 2 varicocele groups in comparison with control, but was statistically not significant between the 2 varicocele groups . Conclusions : Bilateral varicocele causes more significant drop in seminal antioxidant defenses than unilateral varicocele which seems to add a more negative impact on spermatogenesis .