Comparison of oxidative stress intensity in the seminal plasma and serum of patients with different varicocele grades and nonvaricocele subjects

Abstract

Background: Varicocele is the leading cause of male infertility throughout the world. Objectives: This study aimed to identify the effects of varicocele on oxidative stress, total antioxidant capacity (TAC), and semen parameters. Methods: In this cross sectional study, serum and semen samples were collected from nonvaricocele subjects (n, 35) and patients with varicocele (n, 86), who were referred to infertility and in vitro fertilization (IVF) centers of Babol Clinic Hospital, Babol, Mazan-daran Province, Iran during 2015-2016. The semen samples were analyzed according to the world health organization (WHO) guidelines. After ultrasound and physical examinations, varicocele was classified into 3 grades: G1, G2, and G3. TAC and malondialdehyde (MDA) levels were measured in the serum and seminal plasma of subjects, using ferric reducing ability of plasma (FRAP) and thiobarbituric acid reaction (TBAR) methods, respectively. Nitric oxide (NO) was also measured using an NO assay kit. Results: The mean total sperm count in the G1, G2, and G3 groups was significantly lower than that of nonvaricocele men (P = 0.037; P = 0.003, and P = 0.044, respectively). A trend of lower semen volume was observed in the G3 group, compared with the nonvaricocele group (P = 0.06). A significant positive correlation was observed between elevated serum MDA level and varicocele degree (P < 0.05). The MDA level from the highest to the lowest is as follows: G3 > G2 > G1 > nonvaricocele. There was also a significant negative correlation between the serum and seminal plasma TAC levels (P < 0.05). Varicocele patients with G3 degree had a significantly lower mean TAC level in the serum and seminal plasma, compared with nonvaricocele men (P = 0.001 and P = 0.008, respectively). No significant difference was found in the mean NO level between the groups. However, an increasing trend for the mean NO level was observed in the serum and seminal plasma of varicocele patients. Conclusions: The reduced level of seminal plasma antioxidants, which is associated with increased lipid peroxidation, is one of the main reasons for low sperm quality in patients with varicocele. Antioxidant therapy may be useful in decreasing oxidative stress intensity and improving the condition of varicocele patients.