Aim of the work: To evaluate the effect of human chorionic gonadotropin and antioxidants on semen parameters after varicocelectomy in infertile patients.

Patients and Methods: This is a randomized prospective clinical trial. This study included 60 varicocele infertile patient with oligoasthenoteratozoospermia (OAT) undergo varicocelectomy. Patients were randomly divided into four groups : Patients in group (A)  were treated with HCG alone 5000 IU weekly, patients in group (B) were treated with antioxidants alone in the form of vitamins A (1.8mg), C (90mg),

E (15mg), selenium (55mCg), molybdenum (45mCg), mixed bioflavonoids (100mg), zinc (11mg), proanthocyanidins (40 mg),omega3 (450 mg), Alpha Lipoic Acid (40 mg) once daily. Patients in group (C) were treated with HCG and antioxidants together and patients in group (D) didn’t receive any medical   treatment after varicocelectomy. Duration of treatment three months. Semen analysis according to WHO 2010 guidelines was performed before varicocelectomy, and three months after treatments.

Results: All patients in the current study showed statistically significance increase in concentration per ml, progressive motility, sperm morphology and total motility of sperm after three months regardless of treatment modality with more significant clinical results were observed in combined treatment with HCG and antioxidants together after varicocelectomy than anti-oxidant alone, followed by HCG alone, and finally varicocelectomy alone; (p value < 0.001).  

Conclusion:  We concluded that the treatment of patients with varicocele associated with infertility and semen Analysis had showed OAT by varicocelectomy or antioxidant therapy or HCG can significant improving semen parameters, but   medical treatment provides an important contribution to varicocelectomy outcomes