Role of therapy using Human chorionic gonadotropin and anti-oxidants in post varicocelectomy infertile patients. (Randomized clinical trial)

  • Essam Eldin Abd-Aziz Nada
  • Gamal A. Alsagheer
  • Hassan Mohamed Ibrahim
  • Ghada Elsayed Mahmoud
Keywords: Infertility, Varicocele, Varicocelectomy, Antioxidant, HCG.


Aim of the work: To evaluate the effect of human chorionic gonadotropin and antioxidants on semen
parameters after varicocelectomy in infertile patients.
Patients and Methods: This study was randomized prospective clinical trial. This study included 60
varicocele infertile patient with Oligoasthenoteratozoospermia (OAT) undergo varicocelectomy. The patients
were randomly divided into four groups : Patients in group (A) were treated with HCG alone 5000 IU weekly,
patients in group (B) were treated with antioxidants alone in the form of vitamins A (1.8mg), C (90mg),
E (15mg), selenium (55mCg), molybdenum (45mCg), mixed bioflavonoids (100mg), zinc (11mg),
proanthocyanidins (40 mg),omega3 (450 mg), Alpha Llipoilic Acid (40 mg) once daily. Patients in group (C)
were treated with HCG and antioxidants together and patients in group (D) didn’t receive any medical
treatment after varicocelectomy. Duration of treatment three months. Semen analysis according to WHO 2010
guidelines was performed before varicocelectomy, and three months after treatments.
Results: All patients in the current study showed statistically significance increase in concentration per ml,
progressive motility, sperm morphology and total motility of sperm after three months regardless of treatment
modality with more significant clinical results were observed in combined treatment with HCG and
antioxidants together after varicocelectomy than anti-oxidant alone, followed by HCG alone, and finally
varicocelectomy alone; (p value < 0.001).
Conclusion: We concluded that the treatment of patients with varicocele associated with infertility and semen
Analysis had showed OAT by Varicocelectomy or Antioxidant therapy or HCG can significant improving
semen parameters, but medical treatment provides an important contribution to varicocelectomy outcomes