The Impact of Varicocele Correction on Semen Analysis in Infertile Men
Kim Drasa (AL)
[Drasa] University of Tirana
Introduction & Objectives: Varicocele is a common problem in men suffering from infertility, affecting 21-41% pts with primary infertility and up to 80% with secondary infertility. We sought to determine whether varicocele surgery offered any benefit on objective semen parameters. Methods: All pts were 18-25 years old and Tanner 5 who undergoing preoperative and postoperative semen analyses (volume, sperm count, motility, and morphology). Testicular size evaluated by Doppler-sonography. Clinical and demographics data were reviewed. Descriptive statics and paired t-testes were used to calculate statistical significance defined as p<0.05. Results: 22 pts were included in this randomized study. They underwent the microsurgical method. Mean varicocele grade was 2.6. Total testicular volume was 29.1(8-41); left testicular volume was 7.2%. Compared to the preoperative semen analysis, microsurgery led to a significant improvement in sperm count (62.3 vs 31.5 million spermatozoid, p<0.005), percent motility (56.7 vs 41.3%, p<0.012). 13 pts (59.1%) had normalized sperm counts; 5 (22.7%) with abnormal morphology (<50%) had postoperative improvement and 4(18.2%) had low sperm counts after microsurgery, respectively. No significant improvement in motility. No significant distinguished in clinical and demographic data. Conclusion: Varicocele has deleterious effects on the testes and testicular function. Semen analyses parameters were significantly improved in a select population of adolescents undergoing microsurgical varicocelectomy. Correction is warranted for couples with documented infertility in which the man suffers from clinical varicocele associated with semen abnormalities and a female factor has been discarded. Treatment does not seem to benefit pts with subclinical varicocele.