EVALUATION OF THE EFFECTIVENESS AND SAFETY OF A NEW METHOD FOR CORRECTING SPERMATOGENESIS’ PARAMETERSIN PATIENTS WHO UNDERWENT MARMAR SURGERY

BACKGROUND: Varicocele is diagnosed in 15–20% of men and is the common cause of male secretory infertility. The Marmar surgery is considered the gold standard for treating varicocele. There is an improvement in parameters of spermogram after surgical treatment, but it is not always possible to achieve normozoospermia and pregnancy.

AIM: To evaluate the effectiveness of a new method for correcting spermatogenesis’ parameters in patients who underwent Marmar surgery.

MATERIALS AND METHODS: The study included 62 patients who underwent the Marmar surgery. Inclusion criteria were the presence of varicocele as a cause of pathozoospermia and infertility in marriage, age from 18 to 45 years. Group 1 consisted of 32 patients who were not prescribed conservative therapy in the postoperative period, group 2 — 30 patients who from the first day of the postoperative period were prescribed the BESTFertil-DHA complex produced by Pharmacor Production LLC, Russia, the daily dose whom includes Omega-3 polyunsaturated fatty acids, including eicosapentaenoic acid — 1320 mg, cosahexaenoic acid — 924 mg, L-carnitine — at least 480 mg, L-arginine — at least 240 mg, coenzyme Q10 — not less than

14 mg, vitamin E — 32 mg, zinc — 20 mg, folic acid — 0.4 mg, glutathione — 40 mg, selenium — 30 mcg, vitamin C — 24 mg, ginsenosides — not less than 26 mg.

RESULTS: Average increase in sperm concentration in 3 months after surgical treatment in patients of group 1 was 9.9 (49.0%) million/ml, while in group 2 it was 22.4 million/ml (106.6%), p < 0.05. The average increase in the number of progressively motile forms of sperm in patients of groups 1 and 2 was 25.5 and 58.8%, respectively (p < 0.05); the average increase in the number of normal forms of sperm is 16.5 and 104.5%, respectively (p < 0.05). In patients with increased sperm DNA fragmentation after 3 months after the operation, there was a significant decrease from 26.1 ± 5.2 to 19.4 ± 7.2% (p < 0.05) in patients of group 1 and from 27.6 ± 6.9 to 14.6 ± 6.2% (p < 0.001) — in patients of group 2. Pregnancy in a married couple after 3 months after surgical treatment it was noted in 1 (3.1%) patient in the group without the use of a biologically active complex, and in 4 (13.3%) patients receiving this complex for 3 months after operation.

CONCLUSIONS: Аdministration of a biologically active complex to patients after Marmar surgery makes it possible to achieve a statistically significant improvement in the main indicators of the spermogram — concentration, sperm motility and the number of morphologically normal forms, as well as reduce the level of sperm DNA fragmentation, which increases the likelihood of fertilization in the natural reproductive cycle.