The study objective is to perform clinical laboratory evaluation of the effectiveness of Prostatilen® AC and Arginine-zinc in treatment of patients with sperm pathology and concomitant varicocele and chronic nonbacterial prostatitis.Materials and methods. The study included 60 patients between 23 and 46 years of age. The first group included 30 patients (15 patients with varicocele and 15 patients with chronic nonbacterial prostatitis) who received Prostatilen® AC. The second group included 30 patients (15 patients with varicocele and 15 patients with chronic nonbacterial prostatitis) who received Arginine-zinc. Therapy duration was 20 days. Standard clinical and laboratory examination, spermiologic examination as well as measurement of antisperm antibodies, DNA fragmentation, oxidative stress level, cryotest, electron microscopy examination of the ejaculate were performed.Results. Five (5) days after the end of therapy, percentage of progressive motile sperm increased by 62 % in the Prostatilen® AC patient group with chronic nonbacterial prostatitis (р <0.001) compared to the baseline, and by only 10 % in the Arginine-zinc patient group. Administration of Prostatilen® AC lead to a more significant decrease of reactive oxygen intermediates in the ejaculate (р <0.001) and percentage of sperm with fragmented DNA (р <0.001) compared to administration of Arginine-zinc. The applied treatment schemes had no significant effect on the number of sperm with acrosomal hypoplasia. An anti-inflammatory effect of Prostatilen® AC was also identified (decreased number of leukocytes in sperm). During the study, 3 cases of adverse effects were registered: 1 after administration of Prostatilen® AC and 2 after administration of Arginine-zinc.Conclusion. Prostatilen® AC can be considered more effective and safer compared to Arginine-zinc for 20-day administration. In patients with sperm pathology, it more effectively improves sperm characteristics: increases sperm motility, sperm morphology, decreases DNA fragmentation and oxidative stress levels.

This review analyzes studies on the negative effects of antibiotics on reproductive organs and their function. Many experimental studies record the negative effect of certain antibiotics, depending on the dose applied, on spermatogenesis. Unlike drugs of other groups, in which a direct cytotoxic effect on the testicular tissue occurs through a change in the level of hormones of the hypothalamic-pituitary-gonadal axis or through a direct effect on the testicle itself, when using some antibiotics, most often against the background of the inflammatory process, oxidative stress occurs in the testicular tissues, which leads to dystrophic lesions and violations of spermatogenesis indicators.

The aim of the study was to evaluate the clinical and laboratory effectiveness of the peptide bioregulator Samprost® in the correction of pathospermia in men with secretory type of infertility caused by chronic nonbacterial prostatitis (CNP) and varicocele in the postoperative period.Materials and methods. The multicenter study included 30 patients between 23 and 51 years of age: 15 patients with CNP (1st group) and 15 men with infertility due to varicocele in the postoperative period (2nd group). Patients of all groups received Samprost® for 20 days in the form of intramuscular injections of 5 mg daily. The study design provided for a traditional clinical, laboratory and specialized examination with the study of the level of antisperm antibodies, the study of sperm DNA fragmentation by the TUNEL method, the assessment of oxidative stress, a cryotolerance test, and an electron microscopic examination of the ejaculate. Statistical processing of the material was carried out using the paired Student's t test for dependent samples, and the Wilcoxon nonparametric T test was also used. The calculations were performed using the SigmaPlot 12.5 program.Results. The average age of the study participants was 36.91 ± 4.5 years (23-51 years). Among the concomitant and past diseases, the most common were patients with recurrent varicocele, May-Turner syndrome, varicose veins of the pelvis. When evaluating the effectiveness, the results of the study showed a more significant effect of the drug Samprost® in the group of patients with CNP. This concerned an increase in ejaculate volume by 11.5 %, an increase in sperm concentration by 19.4 %. Progressive sperm motility increased more in the group of patients with varicocele by 12.2 %, compared with the CNP group - 11.4 %. Similar data were obtained during cryotest.After 20-day use of the Samprost® a significant decrease in the level of free radicals in the ejaculate was noted: by 2.5 times in the group with CNP and by 2.3 in the group of patients with varicocele. Analysis of these indicators may indicate an antioxidant effect on the effect on the sperm cell, which is under serious stress in the fight against free radicals. This assumption is also confirmed by the EMIS data, which showed a positive dynamics in the number of intact heads of normal form with a normal structure of chromatin and acrosome, the number of spermatozoa with insufficiently condensed immature chromatin.Conclusion. Samprost® is an effective and safe drug for patients with secretory type of male infertility. Based on the methods of statistical analysis, including statistically significant differences in the study groups, Samprost® is more effective in patients with secretory type of male infertility in the case of CNP than in patients with varicocele in the postoperative period. More significant changes relate to the volume, concentration of sperm viability and a decrease in the level of free radicalsThe 20-day course of Samprost® increases progressive sperm motility during cryotest in patients with varicocele and CNP and can be used for substantiated preparation of patients for gamete cryopreservation and its use in preparatory assisted reproductive technologies programs using intra cytoplasmic sperm injection. A decrease in DNA fragmentation and the received electron microscopic examination of the sperm data indicate a possible influence of Samprost® on sperm morphology and require further research in this area.