{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T19:51:41Z","timestamp":1780084301264,"version":"3.54.0"},"reference-count":40,"publisher":"The Korean Society for Reproductive Medicine","issue":"3","license":[{"start":{"date-parts":[[2025,7,10]],"date-time":"2025-07-10T00:00:00Z","timestamp":1752105600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["ecerm.org"],"crossmark-restriction":true},"short-container-title":["Clin Exp Reprod Med"],"published-print":{"date-parts":[[2025,9,1]]},"abstract":"<jats:p>Objective: This study emphasizes the role of oxidative stress in the pathogenesis of male infertility\u2014including varicocele\u2014and supports the utility of antioxidant supplementation. The aim of our study is to evaluate the effectiveness of multiantioxidant therapy in improving semen quality, reducing the DNA fragmentation index, and increasing pregnancy rates in oligoasthenozoospermic (OA) patients with different grades of varicocele.Methods: We conducted a prospective study of infertile men with OA and varying grades of varicocele. Serum and semen samples were collected at baseline and after 6 months of treatment from subjects with varicocele grades 0, 1, 2, and 3. Sperm DNA damage, reproductive hormones, and pregnancy rates were evaluated.Results: Significant differences in mean sperm count, total sperm count, sperm motility, and normal sperm morphology were observed among groups G1, G2, G3, and G4 (p&lt;0.0001). Sperm DNA integrity improved significantly in patients with varicocele after oral antioxidant therapy. Pregnancy achieved by intrauterine insemination was observed in 11%, 9%, 1%, and 0.7% of couples in groups G1, G2, G3, and G4, respectively. Additionally, spontaneous pregnancy occurred in 6% and 3% of couples with varicocele grade 0 and grade 1, respectively, after multiantioxidant supplementation. No significant pregnancy rate was observed in groups G3 and G4.Conclusion: Multiantioxidant therapy produced marked therapeutic benefits in patients with grade 0 and grade 1 varicocele and served as a useful adjuvant in managing varicocele-related infertility.<\/jats:p>","DOI":"10.5653\/cerm.2024.07703","type":"journal-article","created":{"date-parts":[[2025,7,10]],"date-time":"2025-07-10T08:23:26Z","timestamp":1752135806000},"page":"259-267","update-policy":"https:\/\/doi.org\/10.5653\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Evaluation of the effects of multiantioxidant therapy on sperm parameters, reproductive hormones, sperm DNA integrity, and pregnancy rates in infertile men with different grades of varicocele"],"prefix":"10.5653","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4982-1614","authenticated-orcid":true,"given":"Chaymae","family":"Rochdi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meriem","family":"Ouadrhiri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ibtissam","family":"Bellajdel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hafsa","family":"Taheri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanane","family":"Saadi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed","family":"Mimouni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed","family":"Choukri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"3624","reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1080\/14647273.2020.1785117"},{"key":"ref2","first-page":"248","volume-title":"The effects of varicocelectomy on sperm DNA fragmentation and conventional semen parameters in men with severe oligoasthenoteratozoospermia: a prospective study","author":"Rochdi","year":"2024"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1016\/j.euf.2022.08.014"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.11604\/pamj.2023.45.119.38249"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1016\/j.afju.2018.11.002"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1097\/ju.0000000000000311"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1016\/j.explore.2021.07.001"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1007\/s43032-020-00311-6"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1111\/and.14275"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1186\/s12610-020-00112-6"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.4081\/aiua.2020.2.158"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.3389\/frph.2021.695992"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1007\/s00018-019-03253-8"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1111\/and.13576"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1111\/and.13598"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.3389\/fgene.2022.850114"},{"key":"ref17","first-page":"763","volume-title":"Varicocelectomy improves sperm parameters, sperm DNA integrity as well as the other critical semen features","author":"Nakonechnyi","year":"2022"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1111\/and.14533"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.3390\/antiox10071067"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2017.07.403"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.5534\/wjmh.210153"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.5653\/cerm.2023.06555"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.5534\/wjmh.200196"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.5534\/wjmh.190145"},{"key":"ref25","doi-asserted-by":"publisher","DOI":"10.1007\/s12011-020-02251-3"},{"key":"ref26","first-page":"470","volume-title":"A global survey of reproductive specialists to determine the clinical utility of oxidative stress testing and antioxidant use in male infertility","author":"Agarwal","year":"2021"},{"key":"ref27","doi-asserted-by":"publisher","DOI":"10.5152\/tud.2022.22058"},{"key":"ref28","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2021.08.014"},{"key":"ref29","doi-asserted-by":"publisher","DOI":"10.18502\/jri.v25i1.15194"},{"key":"ref30","doi-asserted-by":"publisher","DOI":"10.30565\/medalanya.849413"},{"key":"ref31","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-030-89340-8_10"},{"key":"ref32","doi-asserted-by":"publisher","DOI":"10.3109\/14647273.2015.1050462"},{"key":"ref33","doi-asserted-by":"publisher","DOI":"10.1080\/13685538.2020.1769589"},{"key":"ref34","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-410x.2007.06800.x"},{"key":"ref35","doi-asserted-by":"publisher","DOI":"10.1038\/s41443-018-0109-4"},{"key":"ref36","doi-asserted-by":"publisher","DOI":"10.3390\/jcm11216391"},{"key":"ref37","doi-asserted-by":"publisher","DOI":"10.5005\/jp-journals-10016-1147"},{"key":"ref38","doi-asserted-by":"publisher","DOI":"10.3109\/21681805.2013.868513"},{"key":"ref39","doi-asserted-by":"publisher","DOI":"10.7860\/jcdr\/2016\/18464.7657"},{"key":"ref40","doi-asserted-by":"publisher","DOI":"10.1007\/s11255-018-1839-4"}],"container-title":["Clinical and Experimental Reproductive Medicine"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/ecerm.org\/upload\/pdf\/cerm-2024-07703.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/ecerm.org\/journal\/view.php?doi=10.5653\/cerm.2024.07703","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/ecerm.org\/upload\/pdf\/cerm-2024-07703.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T06:51:50Z","timestamp":1756450310000},"score":1,"resource":{"primary":{"URL":"http:\/\/ecerm.org\/journal\/view.php?doi=10.5653\/cerm.2024.07703"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,1]]},"references-count":40,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2025,9]]}},"URL":"https:\/\/doi.org\/10.5653\/cerm.2024.07703","relation":{},"ISSN":["2233-8233","2233-8241"],"issn-type":[{"value":"2233-8233","type":"print"},{"value":"2233-8241","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,1]]},"assertion":[{"value":"2024-11-20","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-02-05","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-07-10","order":2,"name":"published","label":"Published online","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-09-01","order":3,"name":"published","label":"Print publication","group":{"name":"publication_history","label":"Publication History"}}]}}