Varicocelectomy versus antioxidants in infertile men with isolated teratozoospermia: A retrospective analysis.

Objective: To compare the outcome of microscopic subinguinal varicocelectomy versus oral antioxidants for the management of male infertility due to isolated teratozoospermia.

Material and methods: Clinical patients' database of a tertiary infertility referral center was retrospectively reviewed to collect data on male infertility due to isolated teratozoospermia from July 2014 to January 2019. Seventy-two patients who underwentmicroscopic subinguinal varicocelectomy for their clinically palpable varicoceles were considered as a study group, while 60 patients who were treated with antioxidants (L-carnitine, vitamin C, and vitamin E) were included as controls. The improvement in the sperm morphology, sperm DNA fragmentation (SDF), and the achievement of natural pregnancy were compared between the two groups.

Results: In the varicocelectomy group, all sperm parameters and SDF statistically improved 6months after the operation (P-value <.001). In the control group, the percentage of sperm morphology and SDF statistically improved 6months after the treatment (P-value <.05). The improvement in sperm parameters, SDF, and the pregnancy rate was statistically higher in the varicocelectomy group compared to the control group. Within the range of follow-up (12-18 months), 30.5% of patients' partners achieved natural pregnancy in the varicocelectomy groups compared to 16.7% in the control group.

Conclusion: We believe that varicocelectomy has a positive effect on the sperm morphology, SDF, and pregnancy rate in male infertility caused by isolated teratozoospermia.