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. 2016 Apr-Jun;10(1):120-6.
doi: 10.22074/ijfs.2016.4777. Epub 2016 Apr 5.

A Preliminary Study: N-acetyl-L-cysteine Improves Semen Quality following Varicocelectomy

Foroogh Barekat  1 , Marziyeh Tavalaee  2 , Mohammad Reza Deemeh  2 , Mahsa Bahreinian  2 , Leila Azadi  2 , Homayoun Abbasi  3 , Shahla Rozbahani  4 , Mohammad Hossein Nasr-Esfahani  5
Affiliations

A Preliminary Study: N-acetyl-L-cysteine Improves Semen Quality following Varicocelectomy

Foroogh Barekat et al. Int J Fertil Steril. 2016 Apr-Jun.

Abstract

Background: Surgery is considered the primary treatment for male infertility from clinical varicocele. One of the main events associated with varicocele is excessive production of reactive oxygen species (ROS). N-acetyl-L-cysteine (NAC), an antioxidant that scavenges free radicals, is considered a supplement to alleviate glutathione (GSH) depletion during oxidative stress. Despite beneficial effects of NAC in other pathological events, there is no report on the effect of NAC in individuals with varicocele. Therefore, the aim of this study is to evaluate the outcome of NAC on semen quality, protamine content, DNA damage, oxidative stress and fertility following varicocelectomy.

Materials and methods: This prospective clinical trial included 35 infertile men with varicocele randomly divided into control (n=20) and NAC (n=15) groups. We assessed semen parameters, protamine content [chromomycin A3 (CMA3)], DNA integrity [terminal deoxynucleotidyltransferase-mediated dUTP nick-end labeling (TUNEL)] and oxidative stress [2', 7'-dichlorodihydrofluorescein-diacetate (DCFH-DA)] before and three months after varicocelectomy.

Results: Percentage of abnormal semen parameters, protamine deficiency, DNA fragmentation and oxidative stress were significantly decreased in both groups compared to before surgery. We calculated the percentage of improvement in these parameters compared to before surgery for each group, then compared the results between the groups. Only percentage of protamine deficiency and DNA fragmentation significantly differed between the NAC and control groups.

Conclusion: The results of this study, for the first time, revealed that NAC improved chromatin integrity and pregnancy rate when administered as adjunct therapy post-varico- celectomy (Registeration Number: IRCT201508177223N5).

Keywords: DNA Fragmentation; NAC; Oxidative Stress; Protamines; Varicocele.

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Figures

Fig.1
Fig.1
Comparison of sperm parameters before and after surgery in A. N-acetyl-L-Cysteine (NAC) and B. Control group. *; Indicate significant difference before and after surgery.
Fig.2
Fig.2
Comparison of different parameters before and after surgery in A. N-acetyl-L-cysteine (NAC) and B. Control groups. *; Indicate significant difference before and after surgery and ROS; Reactive oxygen species.
Fig.3
Fig.3
Comparison of percentage of improvement in semen parameters in N-acetyl-L-cysteine (NAC) and control groups.
Fig.4
Fig.4
Comparison of percentage improvement in different parameters in N-acetyl-L-cysteine (NAC) and control groups. *; Indicate significant difference between NAC and control groups and ROS; Reactive oxygen species.
See this image and copyright information in PMC

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