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Due to limited access to human testicular tissue, animal model studies have been used to evaluate molecular and, recently, epigenetic changes attributed to pathophysiology induced by VCL.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This review aims to provide an update on the latest findings regarding the link between VCL\u2010induced biochemical stress and molecular changes in germ cells and spermatozoa. Endocrine and antioxidant status, testicular chaperone\u2010specific hemostasis failure, altered testicular ion balance, metabolic disorders, and altered carbon cycling during spermatogenesis are among the many features that will be presented.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Literature review coupled with our own findings suggests that ionic imbalance, hypoxia, hyperthermia, and altered blood flow could lead to severe chronic oxidative and nitrosative stress in patients with VCL leading to defective spermatogenesis and impairment of the integrity of all sperm cell components and compartments down to the epigenetic information they carry.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Since oxidative stress is an important feature of the reproductive pathology of VCL, therapeutic strategies such as the administration of appropriate antioxidants could be undertaken as a complementary non\u2010invasive treatment line.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/andr.12940","type":"journal-article","created":{"date-parts":[[2020,11,4]],"date-time":"2020-11-04T02:25:47Z","timestamp":1604456747000},"page":"546-558","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":43,"title":["Varicocoele and oxidative stress: New perspectives from animal and human studies"],"prefix":"10.1111","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4309-4831","authenticated-orcid":false,"given":"Mazdak","family":"Razi","sequence":"first","affiliation":[{"name":"Department of Basic Sciences Faculty of Veterinary Medicine Urmia University Urmia Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9954-964X","authenticated-orcid":false,"given":"Marziyeh","family":"Tavalaee","sequence":"additional","affiliation":[{"name":"Department of Animal Biotechnology Reproductive Biomedicine Research Center Royan Institute for Biotechnology ACECR Isfahan Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4692-3831","authenticated-orcid":false,"given":"Farshid","family":"Sarrafzadeh\u2010Rezaei","sequence":"additional","affiliation":[{"name":"Department of Surgery and Diagnostic Imaging Faculty of Veterinary Medicine Urmia University Urmia Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1291-4390","authenticated-orcid":false,"given":"Aron","family":"Moazamian","sequence":"additional","affiliation":[{"name":"CellOxess LLC Ewing New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3955-3297","authenticated-orcid":false,"given":"Parviz","family":"Gharagozloo","sequence":"additional","affiliation":[{"name":"CellOxess LLC Ewing New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3077-6558","authenticated-orcid":false,"given":"Jo\u00ebl R.","family":"Drevet","sequence":"additional","affiliation":[{"name":"Faculty of Medicine GReD Institute INSERM U1103 CNRS UMR6293 Universit\u00e9 Clermont Auvergne Clermont\u2010Ferrand France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1983-3435","authenticated-orcid":false,"given":"Mohammad\u2010Hossein","family":"Nasr\u2010Eshafani","sequence":"additional","affiliation":[{"name":"Department of Animal Biotechnology Reproductive Biomedicine Research Center Royan Institute for Biotechnology ACECR Isfahan Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,12,6]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.4103\/1008-682X.172640"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1439-0272.2007.00766.x"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1159\/000314226"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.5534\/wjmh.170053"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.100.1.112"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/humupd\/7.1.59"},{"issue":"7","key":"e_1_2_9_8_1","first-page":"194","article-title":"Antegrade pampiniform plexus venography in recurrent varicocele: case report and anatomy review. 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