Department of Urology, Afzalipour School of Medicine, Kerman University of Medical Sciences, Kerman, Iran.
J Assist Reprod Genet. 2013 Apr;30(4):593-9. doi: 10.1007/s10815-013-9961-9. Epub 2013 Feb 24.
Surgical repair of varicocele has long been a procedure to correct spermatogenesis. However, the outcome has been reported to be inadequate. We combined varicocelectomy with supplement therapy to evaluate the concurrent effect of these procedures.
A prospective randomized controlled study was undertaken to investigate the effects of zinc sulfate, folic acid and zinc sulfate/folic acid on sperm quality, protamine content and acrosomal integrity following surgical repair of varicocele. Male subjects with palpable varicocele were included in the study and randomized into four groups. Subjects received Zinc sulfate, Folic acid, Zinc sulfate/Folic acid or placebo for 6 months. A semen sample was obtained before surgery and 3 and 6 months after surgical repair. Semen samples were evaluated for sperm parameters as well as chromatin content and acrosomal integrity.
Most of the evaluated parameters showed a mild improvement after varicocelectomy in the placebo group. Interestingly, co-administration of Zinc sulfate and folic acid improved most factors significantly. Folic acid administration but not zinc sulfate could increase sperm number. Hence, Zinc sulfate was better than folic acid when change in morphology was assessed, and none of them was significantly effective in sperm motility. In Zinc sulfate and Folic acid groups, protamine content and halo formation rate significantly improved.
We may conclude that co-administration of zinc and folic acid significantly improved sperm parameters and increased varicocelectomy outcomes. So, medical treatment with compatible drugs after surgery might be advantageous for obtaining acceptable results.
精索静脉曲张的手术修复长期以来一直是纠正精子发生的一种方法。然而，其结果报告并不理想。我们将精索静脉切除术与补充治疗相结合，以评估这些治疗方法的同时效果。
进行了一项前瞻性随机对照研究，以调查硫酸锌、叶酸和硫酸锌/叶酸对精索静脉曲张手术后精子质量、精蛋白含量和顶体完整性的影响。纳入研究的男性患者均有可触及的精索静脉曲张，并随机分为四组。患者接受硫酸锌、叶酸、硫酸锌/叶酸或安慰剂治疗 6 个月。在手术前、手术后 3 个月和 6 个月获取精液样本。评估精液参数以及染色质含量和顶体完整性。
在安慰剂组中，精索静脉结扎术后大多数评估参数显示出轻度改善。有趣的是，同时给予硫酸锌和叶酸可显著改善大多数因素。叶酸给药而非锌给药可增加精子数量。因此，在评估形态变化时，硫酸锌优于叶酸，而在精子运动方面，两者均无显著效果。在硫酸锌和叶酸组中，精蛋白含量和晕环形成率显著改善。
我们可以得出结论，锌和叶酸的联合给药可显著改善精子参数，并增加精索静脉曲张的手术效果。因此，手术后使用相容的药物进行治疗可能有利于获得可接受的结果。
