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.
Studieoversikt
Status
Detaljert beskrivelse
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.
Studietype
Registrering (Antatt)
Fase
- Fase 3
Kontakter og plasseringer
Studiekontakt
- Navn: Mohamed Dogha, MD
- Telefonnummer: 00201010044612 01010044612
- E-post: mma16@fayoum.edu.eg
Studiesteder
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Al Fayyum, Egypt, 63514
- Mohamed Mahmoud Dogha
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Deltakelseskriterier
Kvalifikasjonskriterier
Alder som er kvalifisert for studier
Tar imot friske frivillige
Kjønn som er kvalifisert for studier
Beskrivelse
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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Studieplan
Hvordan er studiet utformet?
Designdetaljer
- Primært formål: Behandling
- Tildeling: Randomisert
- Intervensjonsmodell: Parallell tildeling
- Masking: Ingen (Open Label)
Våpen og intervensjoner
Deltakergruppe / Arm |
Intervensjon / Behandling |
|---|---|
|
Eksperimentell: 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. |
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Aktiv komparator: 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. |
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Placebo komparator: 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. |
Hva måler studien?
Primære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
|---|---|---|
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semen analysis sperm concentration
Tidsramme: 3 and 6 months post-intervention.
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Assessment of improvement in semen analysis parameters sperm concentration |
3 and 6 months post-intervention.
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semen analysis sperm motility
Tidsramme: 3 and 6 months post-intervention.
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Assessment of improvement in semen analysis parameters sperm motility |
3 and 6 months post-intervention.
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semen analysis sperm morphology
Tidsramme: 3 and 6 months post-intervention.
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Assessment of improvement in semen analysis parameters: sperm morphology |
3 and 6 months post-intervention.
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Sekundære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
|---|---|---|
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Spontaneous pregnancy rate (incidence of pregnancy)
Tidsramme: within 1 year postoperative
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Spontaneous pregnancy rate (incidence of pregnancy) |
within 1 year postoperative
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Incidence and profile of medical treatment side effects.
Tidsramme: within 3 to 6 months postoperative
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Incidence and profile of medical treatment side effects. |
within 3 to 6 months postoperative
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Samarbeidspartnere og etterforskere
Sponsor
Studierekorddatoer
Studer hoveddatoer
Studiestart (Antatt)
Primær fullføring (Antatt)
Studiet fullført (Antatt)
Datoer for studieregistrering
Først innsendt
Først innsendt som oppfylte QC-kriteriene
Først lagt ut (Faktiske)
Oppdateringer av studieposter
Sist oppdatering lagt ut (Faktiske)
Siste oppdatering sendt inn som oppfylte QC-kriteriene
Sist bekreftet
Mer informasjon
Begreper knyttet til denne studien
Ytterligere relevante MeSH-vilkår
Andre studie-ID-numre
- R-872
Plan for individuelle deltakerdata (IPD)
Planlegger du å dele individuelle deltakerdata (IPD)?
IPD-planbeskrivelse
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.
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