Add-on effects of oral tocopherol supplementation to surgical varicocelectomy on the outcome of assisted reproductive technology: a single-center pilot study report

Teppei Takeshima; Takahiro Mihara; Makoto Tomita; Shinnosuke Kuroda; Yasushi Yumura; Hiroe Ueno; Mizuki Yamamoto; Mariko Murase

doi:10.3389/frph.2023.1325566

Add-on effects of oral tocopherol supplementation to surgical varicocelectomy on the outcome of assisted reproductive technology: a single-center pilot study report

Front Reprod Health. 2024 Jan 22:5:1325566. doi: 10.3389/frph.2023.1325566. eCollection 2023.

Authors

Teppei Takeshima^{1

2}, Takahiro Mihara¹, Makoto Tomita¹, Shinnosuke Kuroda^{2

3}, Yasushi Yumura², Hiroe Ueno⁴, Mizuki Yamamoto⁴, Mariko Murase⁴

Affiliations

¹ Department of Health Data Science, Yokohama City University Graduate School of Data Science, Yokohama, Kanagawa, Japan.
² Department of Urology, Reproduction Center, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan.
³ Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic Foundation, Cleveland, OH, United States.
⁴ Department of Gynecology, Reproduction Center, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan.

Abstract

Introduction: Varicocelectomy is well known to improve the pregnancy outcome of patients with clinical varicoceles in assisted reproductive technologies as well as spontaneous conception. Therefore, this study aimed to evaluate the additional effects of oral antioxidant therapy after varicocelectomy on the pregnancy outcome in the assisted reproductive technology setting.

Methods: This study was a retrospective cohort study. The subjects were couples among whom the male partner had undergone varicocelectomy and was scheduled for subsequent assisted reproductive technology. Pregnancy outcomes were followed retrospectively in 62 couples with male partners who received tocopherol (antioxidant group) and 37 couples who did not (control group). The tocopherol and control groups were assigned dependent on the decision of the physician in charge and the patient's request. The clinical pregnancy rates per couple and embryo transfer, time to pregnancy, and the number of cycles during transfer to pregnancy were evaluated.

Results: No significant differences were observed in the pregnancy rate per couple (antioxidant group 70.9% vs. control group 64.9%, P = 0.55) and per embryo transfer (50.4% vs. 39.6%, P = 0.22). Regarding the time to event analyzed by adjusted restricted mean survival time, the mean time to pregnancy was significantly shorter in the antioxidant (tocopherol) group (14.2 vs. 17.4 months, P = 0.025). No significant difference was observed in the embryo transfer cycle to pregnancy (mean embryo transfer cycles: 2.6 vs. 3.0, P = 0.238).

Conclusions: Additional oral tocopherol nicotinate as antioxidant therapy after varicocelectomy was shown to shorten the time to pregnancy. It is recommended that add-on effects be tested in more well-designed randomized controlled trials to examine whether it improves assisted reproductive outcomes.

Keywords: antioxidant; assisted reproductive technology; oxidative stress; tocopherol nicotinate; varicocele; varicocelectomy.

Grants and funding

The authors declare that no financial support was received for the research, authorship, and/or publication of this article.