Abstract
<jats:p>Introduction. Infertility affects up to 15% of married couples worldwide, with the male factor accounting for infertility in 50% of cases. Varicocele is diagnosed in 15–20% of men and is the most common cause of secretory male infertility. The Marmar procedure is justifiably considered the «gold standard» in the treatment of varicocele. After surgical treatment, improvement in semen parameters is observed; however, it is not always possible to achieve normozoospermia and conception. Objective of the study. To evaluate the effectiveness of using the BESTFertil-DHA complex in patients after Marmar surgery. Material and methods. The study included 62 patients who underwent microsurgical subinguinal varicocelectomy using the standard Marmar technique for varicocele with associated reproductive dysfunction. Patients were randomized into two groups. The first group included 32 patients who did not receive conservative therapy postoperatively, and the second group included 30 patients who were prescribed the BESTFertil-DHA complex from the first postoperative day for 3 months according to the recommended regimen. Inclusion criteria were varicocele as the cause of pathozoospermia and infertility in the couple, and age between 18 and 45 years. Results. Three months after surgery, the concentration and percentage of progressively motile sperm increased significantly in both groups. In group 1, the average increase in sperm concentration was 3.8 (18.8%) million/mL, whereas in group 2 it was 7.5 (36%) million/mL (p<0.05). The average increase in the percentage of progressively motile spermatozoa was 8.2% in group 1 and 21.8% in group 2, respectively (p<0.05); the average increase in the percentage of morphologically normal forms of spermatozoa (according to strict Kruger criteria) was 16.7% and 36.4%, respectively. In both groups, among patients with pathological sperm DNA fragmentation index (DFI), there was a significant decrease in sperm DNA fragmentation three months after surgery: from 26.1 (5.2)% to 22.4 (11.2)% (p<0.05) in the first group and from 27.6 (8.9)% to 14.6 (6.2)% (p<0.05) in the second group. Pregnancy occurred in 1 couple (3.1%) in the group without BESTFertil-DHA and in 4 couples (13.3%) in the group that received BESTFertil-DHA during the 3 months following varicocele surgery. Conclusion. The obtained results indicate that the use of the BESTFertil-DHA complex in patients after Marmar surgery allows for a statistically significant improvement in key semen parameters—sperm concentration, motility, and percentage of morphologically normal forms—as well as a reduction in sperm DNA fragmentation index, which increases the likelihood of fertilization in a natural reproductive cycle. Keywords: Marmar surgery, semen analysis, male infertility, fertility, BESTFertil-DHA.</jats:p>