Past Issue

Volume 10, Number 1, Apr-Jun 2016, Pages: 120-126

A Preliminary Study: N-acetyl-L-cysteine Improves Semen Quality following Varicocelectomy

Foroogh Barekat, M.Sc, 1, 2, Marziyeh Tavalaee, M.Sc, 1, Mohammad Reza Deemeh, M.Sc, 1, Mahsa Bahreinian, M.Sc, 1, Leila Azadi, M.Sc, 1, Homayoun Abbasi, M.D, 3, Shahla Rozbahani, Ph.D, 2, Mohammad Hossein Nasr-Esfahani, Ph.D, 1, 3, *,
Department of Reproductive Biotechnology, Reproductive Biomedicine Research Center, Royan Institute for Biotechnology, ACECR, Isfahan, Iran
Department of Biology, Flavarjan Branch, Islamic Azad University, Flavarjan, Isfahan, Iran
Isfahan Fertility and Infertility Center, Isfahan, Iran
*Corresponding Address: P.O.Box: 8165131378 Department of Reproductive Biotechnology Reproductive Biomedicine Research Center Royan Institute for Biotechnology ACECR Isfahan Iran



Surgery is considered the primary treatment for male infertility from clinical varicocele. One of the main events associated with varicocele is excessive production of reactive oxygen species (ROS). N-acetyl-L-cysteine (NAC), an antioxidant that scavenges free radicals, is considered a supplement to alleviate glutathione (GSH) depletion during oxidative stress. Despite beneficial effects of NAC in other pathological events, there is no report on the effect of NAC in individuals with varicocele. Therefore, the aim of this study is to evaluate the outcome of NAC on semen quality, protamine content, DNA damage, oxidative stress and fertility following varicocelectomy.

Materials and Methods

This prospective clinical trial included 35 infertile men with varicocele randomly divided into control (n=20) and NAC (n=15) groups. We assessed semen parameters, protamine content [chromomycin A3 (CMA3)], DNA integrity [terminal deoxynucleotidyltransferase-mediated dUTP nick-end labeling (TUNEL)] and oxidative stress [2', 7'-dichlorodihydrofluorescein-diacetate (DCFH-DA)] before and three months after varicocelectomy.


Percentage of abnormal semen parameters, protamine deficiency, DNA fragmentation and oxidative stress were significantly decreased in both groups compared to before surgery. We calculated the percentage of improvement in these parameters compared to before surgery for each group, then compared the results between the groups. Only percentage of protamine deficiency and DNA fragmentation significantly differed between the NAC and control groups.


The results of this study, for the first time, revealed that NAC improved chromatin integrity and pregnancy rate when administered as adjunct therapy post-varico- celectomy (Registeration Number: IRCT201508177223N5).