Seminal quercetin in sub fertile men with and without varicocele: a case-control study

Abstract

Introduction: Oxidative stress (OS) that impairs sperm function is recognized as a key factor in male infertility. Quercetin, a natural antioxidant flavonoid, may play a protective role in maintaining semen quality, but its seminal levels in sub fertile men remain underexplored.

Objective: To quantify seminal quercetin levels in sub fertile men with and without varicocele and evaluate its role as an antioxidant in mitigating oxidative stress (OS)-induced male infertility.

Materials and Methods: This case-control study was conducted in Imran Idrees Teaching Hospital, Sialkot Pakistan on three groups: healthy fertile males (control-group, n=11), sub-fertile males without varicocele (V- group, n=22), and sub-fertile males with varicocele (V+ group, n=11). Semen samples were collected following 3–4 days of abstinence followed by sperm analysis. Seminal quercetin levels were quantified using high-performance liquid chromatography (HPLC), and statistical comparisons between groups were made using the Kruskal-Wallis test followed by multiple comparisons test.

Results: Semen analysis revealed a significantly reduced sperm count, motility, and progressive motility in both the V- and V+ groups, with a more pronounced reduction observed in V+ group (p<0.001). Seminal quercetin levels were significantly lower in the V+ group (353.92 ± 68.61 µg/mL) and V- group (261.21 ± 55.22 µg/mL) compared to healthy controls (865.84 ± 227.00 µg/mL, p<0.001). OS was more pronounced in sub fertile men, particularly those with varicocele, contributing to poor semen parameters.

Conclusion: This study demonstrates markedly reduced seminal quercetin levels in sub fertile men, with the lowest levels observed in those with varicocele. These findings highlight oxidative stress as a major contributor to impaired semen quality.