Objectives: Varicocele is the most common cause of male infer- tility. It affects spermatogenesis  by multiple theories, the most recent is by increasing the levels of reactive oxygen species. Medical treatment in the form of tamoxifen, anti-oxidant (Zinc) and MPFF (Micronised purified flavonoid fractions), may improve sper- matogenesis and semen parameters in patients with varicocele.

Our study aims to show the efficacy of medical treatment on semen parameters  and varicocele  degree in varicocele  patients with oligoasthenoteratozoospermia (OAT).

Material and Methods: This study included 60 male patients with varicocele and OAT. Clinical and radiological assessment of varicocele and WHO semen analysis have been performed before and 3 months after medical treatment. Patients were treated with Tamoxifen 20 mg / day, Oral Zinc and (Diosmin 450 mg and Hesperidin 50 mg) 3 time / day for 3 months.

Results: There was a statistically significant  increase in sperm concentration, progressive  sperm motility, total sperm motility and sperm morphology (p ¼.009, .005, .020, 0.001) after 3 months of treatment. No significant changes in varicocele degree and veins diameter after treatment.

Conclusion: Medical treatment with Tamoxifen 20 mg / day, Oral Zinc and (Diosmin 450 mg and Hesperidin 50 mg) 3 time / day for 3 months has a significant  beneficial effect on sperm concentration, Progressive motility,  morphology  and   total motility. It has no significant effect on decreasing vein   diameter of varicocele or presence of reflux.