Τίτλος:
Vitamins as primary or adjunctive treatment in infertile men with
varicocele: A systematic review
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Objective: To investigate the usage and the efficacy of vitamins as
primary or adjuvant treatment in infertile men with varicocele.
Methods: A systematic search in PubMed, the Medical Literature Analysis
and Retrieval System Online (MEDLINE) and Cochrane Library with the
terms (varicocele) AND (vitamins) was performed. We searched for
studies: a) reporting the administration of vitamins (individually or as
part of a complex) in men with varicocele and infertility, b) primarily
or adjuvant to invasive treatment, and c) reporting the impact on semen
parameters and/or pregnancy rates. Exclusion criteria were animal,
adolescent and non-English studies, grey literature and trials reporting
abstracts only.
Results: Seven studies were identified eligible for qualitative
analysis. All studies were randomised except one (case series). Vitamins
were administered dominantly as part of antioxidant complex and only two
studies used vitamins (C and E, respectively) as sole agent. In two
studies, vitamin monotherapy resulted in improvement in semen quality,
but the effect on pregnancy rates is unknown. One study reported no
efficacy of adjuvant multivitamin treatment after embolisation in terms
of both semen quality and pregnancy rates. Finally, four studies
reported a positive effect of vitamins on semen parameters after
varicocelectomy, but the effect on pregnancy rates is conflicting; one
study reported improved pregnancy rates with adjuvant treatment, two
studies did not evaluate the pregnancy rates, and in one study the
outcome was unclear due to missing data.
Conclusions: Vitamins have been used mostly as part of an antioxidant
panel for the management of infertile men with varicocele. Most studies
have found a positive impact on semen parameters in selected men with
varicocele and infertility, as primary or adjuvant treatment. However,
the clinical benefit of vitamins administration on pregnancy rate is
under-evaluated and should be the target of future research.
Συγγραφείς:
Tsampoukas, Georgios
Gkeka, Kristiana
Dellis, Athanasios and
Brown, Dominic
Katsouri, Antigoni
Alneshawy, Ahmed
Moussa,
Mohamad
Papatsoris, Athanasios
Buchholz, Noor
Περιοδικό:
Arab Journal of Urology
Εκδότης:
TAYLOR & FRANCIS LTD LONDON
Λέξεις-κλειδιά:
Male infertility; vitamins; semen parameters; pregnancy rates;
varicocele
DOI:
10.1080/2090598X.2021.1932124
