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Effects of supplement therapy on sperm parameters, protamine content and acrosomal integrity of varicocelectomized subjects



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, Follic acid, Zinc sulfate/Follic 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 Follic 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.

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Kerman medical University infertility center members are acknowledged for their warm cooperation in this study

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The authors have no conflict of interest to declare.

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Correspondence to Seyed Noureddin Nematollahi-mahani.

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Capsule In a prospective randomized trial, 6 months supplement therapy in varicocelectomized patients improved sperm parameters, acrosomal integrity and chromatin content.

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Azizollahi, G., Azizollahi, S., Babaei, H. et al. Effects of supplement therapy on sperm parameters, protamine content and acrosomal integrity of varicocelectomized subjects. J Assist Reprod Genet 30, 593–599 (2013).

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  • Zinc sulfate
  • Folic acid
  • Sperm parameters
  • Protamine
  • Acrosomal integrity
  • Varicocelectomy