Comparative Study of Post-Varicocelectomy Myo-inositol vs. Antioxidants vs. Surgery Alone in Infertile Men (MYO-VAR)
Comparative Study Between Myo-inositol Add on Post Varicocelectomy Versus Add on Conventional Antioxidants or Varicocelectomy Alone in Infertile Patients
The purpose of this open-label, 3-arm randomized controlled trial is to compare the clinical efficacy and safety of adding oral myo-inositol versus conventional oral antioxidants (vitamin C, L-carnitine, and zinc) versus surgery alone following microscopic subinguinal varicocelectomy in infertile adult males with clinical varicocele.
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Varicocele is present in approximately 40% of infertile males. While microscopic varicocelectomy remains the gold-standard surgical correction, post-operative oxidative stress and impaired spermatogenesis frequently require adjunctive metabolic or antioxidant support. Myo-inositol plays a critical role in Sertoli cell function, sperm maturation, mitochondrial energy production, and intracellular calcium mobilization essential for sperm hyperactivation. In this prospective study, 150 male patients with clinical Grade II-III varicocele undergoing microscopic subinguinal varicocelectomy at Fayoum University Hospitals will be randomly assigned (1:1:1) into three parallel groups: Group A: Receives oral myo-inositol supplementation for 3-6 months postoperatively. Group B: Receives conventional oral antioxidant combination therapy for 3-6 months post-operatively. Group C: Receives no adjuvant medical treatment post-operatively. All subjects undergo standardized preoperative evaluation (hormone profile, seminal fluid analysis, scrotal duplex) and postoperative follow-up to assess semen parameter improvement, clinical pregnancy rates, and treatment side effects.
Study Type
Enrollment (Estimated)
Phase
- Phase 3
Contacts and Locations
Study Contact
- Name: Mohamed Dogha, MD
- Phone Number: 00201010044612 01010044612
- Email: mma16@fayoum.edu.eg
Study Locations
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-
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Al Fayyum, Egypt, 63514
- Mohamed Mahmoud Dogha
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Adult male patients.
Clinically palpable Grade II or Grade III varicocele undergoing varicocelectomy.
Presence of primary or secondary infertility.
Impaired semen analysis parameters.
Reduced testicular volume.
Exclusion Criteria:
Pediatric (infants) or elderly populations.
Sub-clinical varicocele.
History of previous varicocelectomy operations.
Systemic vascular or medical diseases affecting arterial flow (e.g., diabetes mellitus, hypertension, liver disease, hypercholesterolemia).
Active genital tract infections.
Hormonal abnormalities or autism.
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Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
|---|---|
|
Experimental: Group A: Myo-inositol
Surgical Intervention: Microscopic subinguinal varicocelectomy. Drug/Supplement: Oral Myo-inositol 2g tablets, twice daily for 3 to 6 months post-surgery. |
Microscopic subinguinal varicocelectomy followed by oral myo-inositol 2 g tablets twice daily for 3 to 6 months post-surgery. |
|
Active Comparator: Group B: Conventional Antioxidants
Surgical Intervention: Microscopic subinguinal varicocelectomy. Drug/Supplement: Oral Vitamin C (500mg daily) + L-Carnitine (1000mg twice daily) + Zinc (10mg twice daily) for 3 to 6 months post-surgery. |
Microscopic subinguinal varicocelectomy followed by oral vitamin C (500 mg daily) + L-carnitine (1000 mg twice daily) + zinc (10 mg twice daily) for 3 to 6 months post-surgery. |
|
Placebo Comparator: Group C: Varicocelectomy Alone
Microscopic subinguinal varicocelectomy alone with no adjuvant medical therapy post-surgery. |
Microscopic subinguinal varicocelectomy alone with no adjuvant medical therapy post-surgery. |
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
semen analysis sperm concentration
Time Frame: 3 and 6 months post-intervention.
|
Assessment of improvement in semen analysis parameters sperm concentration |
3 and 6 months post-intervention.
|
|
semen analysis sperm motility
Time Frame: 3 and 6 months post-intervention.
|
Assessment of improvement in semen analysis parameters sperm motility |
3 and 6 months post-intervention.
|
|
semen analysis sperm morphology
Time Frame: 3 and 6 months post-intervention.
|
Assessment of improvement in semen analysis parameters: sperm morphology |
3 and 6 months post-intervention.
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Spontaneous pregnancy rate (incidence of pregnancy)
Time Frame: within 1 year postoperative
|
Spontaneous pregnancy rate (incidence of pregnancy) |
within 1 year postoperative
|
|
Incidence and profile of medical treatment side effects.
Time Frame: within 3 to 6 months postoperative
|
Incidence and profile of medical treatment side effects. |
within 3 to 6 months postoperative
|
Collaborators and Investigators
Sponsor
Study record dates
Study Major Dates
Study Start (Estimated)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- R-872
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
Individual participant data (IPD) will not be made publicly available in open repositories to protect patient privacy and confidentiality, in accordance with the ethical protocol approved by the Institutional Ethical Committee of Fayoum University. Participants provided written informed consent for the publication of aggregated statistical results only, and consent was not obtained for public sharing of individual-level clinical data.
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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