Varicocele is a common cause of male infertility Recent studies at the molecular level
have demonstrated that varicocele can cause testicular nuclear DNA damage,
apoptosis, and raised levels of reactive oxygen species. The present study was carried
out on 120 men: 60 infertile (30 with varicocele and 30 without) and 60 fertile men
(30 with varicocele and 30 without). Varicocele was diagnosed clinically and by
ultrasonography. Standard semen analysis (sperm concentration, motility,
morphology; and seminal leucocytic counts) was performed according to the criteria
presented by World Health Organization in 2010. Then, the seminal plasma was
assessed for levels of oxidants [malondialdehyde (MDA)], antioxidants [ascorbic
acid, glutathione peroxidase (GPx), catalase (CAT), superoxide dismutase (SOD)]
and seminal antiapoptotic factor; soluble fibroblast associated (sFas) which has been
identified in the testis as a key physiological regulator of apoptosis. The results
revealed that patients with varicocele had significantly higher seminal oxidants (MDA
P< 0.001) and significantly lower seminal antioxidants (SOD, GPx, CAT and
ascorbic acid; P < 0.001) and sFas; (P<0.001); as compared to men without
varicocele whether fertile or infertile. Patients with grade3 varicocele had
significantly higher seminal oxidants, and significantly lower antioxidants and sFas
as compared to grade 1 varicoceles (P<0.001). Also, infertile men with or without
varicocele had significantly higher seminal oxidants (MDA P<0.001) and
significantly lower seminal antioxidants (SOD, GPx, CAT and ascorbic acid;
P<0.001) and sFas; (P<0.001); compared to fertile men with or without varicocele.
Moreover, sperm concentrations in men with varicocele (fertile and infertile showed
significant positive correlations with the levels of ascorbic acid (r=0.882 &
0.626,respectively, P<0.001 for each); with the activity of SOD (r=0.901&0.711
respectively, P<0.001 for each), GPx (r=0.909 &0.703 respectively, P<0.001 for
each), CAT (r=0.751&0.679 respectively, P<0.001 for each), and sFas (r=0.750
&0.542, P<0.001& <0.005 respectively), and significant negative correlations with
the levels of MDA (r= -0.896 & - 0.732 respectively, P<0.001 for each), In addition,
sperm motility showed similar correlations as the sperm concentrations.
Conclusions: The present results indicated that varicocele in fertile and infertile men
is associated with increased oxidative stress (indicated with significant increase of
MDA), and significant decrease in seminal antiapoptotic factor (sFas) and
antioxidants (SOD, GPx, CAT and ascorbic acid). These associations were strongly
correlated with increased grade of varicocele.