Fertility of woman and man General Sperm quality

The best supplements for male fertility after varicocele surgery

After varicocele surgery, many patients benefit from additional support with nutritional supplements to help them recover fertility.

It takes two to tango

If a longed-for pregnancy does not occur naturally, experts advise that both partners undergo a medical examination. Although fertility medicine often still revolves around the female partner, we know today, that male fertility issues are just as frequent (actually, this should not be surprising) . A variety of reasons can lead to male fertility problems. Fortunately, many of these are treatable.

Common reason for male infertility: varicocele

One common cause I’d like to talk about in this post is the occurrence of something called a varicocele. Varicocele refers to dilated veins near the scrotum. They cause blood to not be able to drain as normal and back up in the testicle.  The problem: this leads to an increase in temperature in the testicle and, at the same time, to inflammatory reactions and greatly increased oxidative stress. All of this damages the sensitive spermatozoa, reducing male fertility.

Varicocele treatment

Varicoceles do not always require treatment. Whether or not they need to be treated depends on several factors, including severity, symptoms and impact on fertility. Varicoceles are graded according to their severity, typically ranging from grade I (small and not easily palpable) to grade III (large and easily palpable). If the varicocele is small and not causing symptoms or fertility problems, a healthcare provider may recommend regular monitoring without any additional therapy. Grade III varicoceles are much more likely to cause symptoms (discomfort or pain in the scrotum, especially with physical activity or prolonged standing, and subfertility) and may require treatment.  The most common treatment options are varicocelectomy, a surgical procedure in which the dilated veins are ligated or tied off to redirect blood flow. It can be done by open surgery or minimally invasive techniques such as laparoscopy or percutaneous embolization. The latter minimally invasive procedure involves inserting a catheter and using coils or a special solution to block blood flow in the affected veins.

Fertility after varicocele surgery

On average, 60% of all patients have a demonstrably better sperm quality about 3 months after their operation. Approximately one third of patients, however, still have fertility restrictions even after surgical removal of the varicocele.

Support with nutritional supplements

Then, as new research results show, nutritional medicine can provide valuable support: a study from Italy, published in August 2023 in the journal “International Journal of Molecular Sciences”, impressively shows in experiments on rats that anti-inflammatory and antioxidant nutrients in particular can be helpful.

Selenium and lycopene particularly effective

The study examined in particular the trace element selenium and lycopene, which is derived from tomatoes. When these nutrients were given to animals after surgical removal of varicocele, testicular health, testosterone levels, and sperm quality benefited. Both nutrients were particularly effective in combination. Both lycopene and selenium have been used successfully for nutritional support in a variety of other medical conditions. The researchers hypothesize that the anti-inflammatory and antioxidant nutrients may help scavenge lingering inflammation and harmful oxygen radicals after varicocele surgery, thus protecting a man’s sperm quality and ultimately his fertility.


The research shows that a combination of lycopene and selenium (e.g. in Fertilovit® Mplus) together with surgical treatment can contribute to an effective treatment of male infertility in varicocele. Starting from surgery, a 3-month antioxidant cure with selenium and lycopene in interaction with other vital substances important for healthy sperm development (zinc, vitamin E, etc.) is recommended. It is important to know that in nutritional medicine it is by no means true that “a lot helps a lot”, but with certain nutrients an overdose is quite possible, even if they are actually harmless food components. Therefore, a study-tested composition specifically for sperm quality is the first choice. Furthermore, the nutrients should be amended, if necessary, with a vitamin D supplement tailored to the individual situation. To do this, have your vitamin D level determined, preferably when you have your blood drawn anyway before your surgery.



Erdogan O, Ok F. The effect of systemic inflammatory index and systemic inflammatory response index on success of varicoselectomy. Urologia. 2023 Aug 26:3915603231192739. doi: 10.1177/03915603231192739. Epub ahead of print. PMID: 37632401.

Freni J, Pallio G, Marini HR, Micali A, Irrera N, Romeo C, Puzzolo D, Mannino F, Minutoli L, Pirrotta I, Scarfone A, Antonuccio P. Positive Effects of the Nutraceutical Association of Lycopene and Selenium in Experimental Varicocele. Int J Mol Sci. 2023 Aug 31;24(17):13526. doi: 10.3390/ijms241713526. PMID: 37686330; PMCID: PMC10488142.

Nakonechnyi Y, Nakonechnyi A, Fraczek M, Havrylyuk A, Kamieniczna M, Chopyak V, Kurpisz M. Varicocelectomy improves sperm parameters, sperm DNA integrity, and other critical sperm characteristics. J Physiol Pharmacol. 2022 Dec;73(6). doi: 10.26402/jpp.2022.6.09. Epub 2023 Apr 17. PMID: 37087568.


About the author

Dr. rer. nat. Birgit Wogatzky

For many years now, biologist and nutritionist Dr Birgit Wogatzky, has been focusing on the special needs of fertility patients. For the readers of this blog, she sums up interesting novel information and developments from current research projects regarding lifestyle and nutrition of fertility patients.