en <p>Background: The association between varicocele and male infertility has always been a subject of ongoing debate. Lactoferrin (LF) belongs to the transferrin family with iron-binding properties and exhibits many beneficial biological properties. The purpose of the current study was to assess seminal levels of LF in infertile oligoasthenoteratozoospermic (OAT) men with varicocele.<br /> Methods: Sixty-nine men were allocated into three groups; healthy fertile men (as controls) (n=20), infertile OAT men without varicocele (n=19), and infertile OAT men with varicocele (n=30). All men underwent history taking, genital examination, semen analysis, and determination levels of seminal LF by ELISA method. Statistical analysis was carried out using Kruskal-Wallis test followed by post-hoc analysis (Conover) for comparisons involving more than two groups, and the Mann-Whitney U test for comparisons between two groups. Spearman correlation test was used to assess the relationship between variables. The p&gt;0.05 was set as statistically significant.&nbsp;<br /> Results: The median seminal LF level of the healthy fertile controls demonstrated significantly increased levels compared to both groups of infertile OAT men with or without varicocele (p&lt;0.000001). The median seminal LF level of the infertile OAT men with varicocele grade III demonstrated a significant decrease compared to infertile OAT men with grade II (p=0.0057). Collectively, seminal LF levels exhibited significant positive correlations with sperm concentration, total sperm motility, and normal sperm morphology.<br /> Conclusion: LF can be an imperative seminal biomarker that decreases in infertile OAT men especially if associated with varicocele.</p> Male infertility, Lactoferrin, Seminal plasma, Oligoasthenoteratozoospermia (OAT), Varicocele 119 126 https://www.jri.ir/article/140263 https://www.jri.ir/documents/fullpaper/en/140263.pdf Mahmoud FGhalyDepartment of Andrology, Sexology and STIs, Faculty of Medicine, Cairo University, Cairo, Egyptmahmoud.fawzy@kasralainy.edu.eg122851KhadigaAbougabalDepartment of Clinical and Chemical Pathology, Faculty of Medicine, Beni-Suef University, Beni Suef, Egypt122434Ayman AAllamDepartment of Andrology, Sexology and STIs, Faculty of Medicine, Cairo University, Cairo, Egypt122853AyadPalaniDepartment of Clinical Biochemistry, Zanko Central Laboratory, Kalar, Iraq122854TaymourMostafaDepartment of Clinical Biochemistry, Zanko Central Laboratory, Kalar, Iraq122855