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Early and Synergistic Recovery Effect of Herbal Combination on Surgically Corrected Varicocele

Woong Jin Bae, MD; Hyuk Jin Cho, MD, PhD; Sae Woong Choi, PhD; U-Syn Ha, MD, PhD; Sung Hoo Hong, MD, PhD; Sung Yeoun Hwang, PhD; Seung Hwan Jeon, MS; Hyun Cheol Jeong, MD; Su Jin Kim, MD, PhD; Sae Woong Kim, PhD; Eun Bi Kwon, MS; Ji Youl Lee, MD, PhD

Context • Not all men presenting varicocele-associated infertility exhibit improved sperm quality or achieve pregnancy following varicocelectomy. Some combinations of specific natural herbs have been shown empirically to reduce oxidative stress and improve sperm quality. Objective: • We conducted a study to determine the effects of an herbal combination on sperm quality in varicocele-induced rats following varicocelectomy, hoping to find a new treatment approach to restore sperm quality following varicocelectomy. Design • The research team designed an animal study. Setting • The study took place in the Department of Urology at Seoul St. Mary’s Hospital (Seoul, Republic of Korea). Animals • Fifty white, male, Sprague-Dawley rats weighing 250 to 300 g each were used in the study. Intervention • The rats were randomly assigned to 5 groups: (1) a control group (n = 10), (2) varicocele group (n = 10), (3) rats with varicocele and receiving varicocelectomy only (varicocelectomy group, n = 10), (4) rats with varicocele received varicocelectomy and oral administration with 200 mg/kg of an herbal combination for 4 wk (varicocelectomy + 200 mg/kg group, n = 10), and (5) rats with varicocele received varicocelectomy and oral administration with 400 mg/kg of an herbal com for 4 wk (varicocelectomy + 400 mg/kg group, n = 10). Outcome Measures • The study measured (1) sperm concentration and motility, (2) levels of reactive oxygen species (ROS), (3) concentrations of interleukin 6, interleukin 1ß, and tumor necrosis factor alpha (TNF-a), (4) apoptotic change, and (5) levels of heat shock protein (HSP). Results • The sperm concentrations and motilities recovered after treatment in the varicocelectomy, varicocelectomy + 200 mg/kg, and varicocelectomy + 400 mg/kg groups. Significantly increased SOD and decreased ROS and cytokine levels were also observed. The apoptosis in the testes also was significantly decreased compared with the varicocele group. HSP70 in groups received varicocelectomy and administered with herbal combination was significantly decreased compared with the varicocelectomy group. Conclusions • The herbal combination was found to improve the sperm qualities, oxidative stress, and inflammation after varicocelectomy. Therefore, the herbal combination may provide a new and additional treatment for varicocele-associated infertility. For clinical application, further studies are needed to identify active ingredients in each herb and the mechanism by which each ingredient works, to standardize the herbal combination.

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