Does the duration of infertility affect semen parameters and pregnancy rate after varicocelectomy?: a retrospective study

Abstract

Objectives:The most common indication for treatment of varicocele is still male subfertility. The aim of this study was to explore the effect of infertility duration on semen parameters and spontaneous pregnancy rate after varicocelectomy. Materials and Methods:The medical records of 183 infertile patients with clinical varicocele were retrospectively reviewed. The patients were divided into three groups according to the duration of infertility (group I, 1-3 years, group II, 3-6 years and group III, > 6 years). Total sperm motility counts (TMCs) before and after varicocelectomy and spontaneous pregnancy rate among these groups were statistically compared. Results: The greatest changes, regarding preoperative and postoperative TMCs and spontaneous pregnancy rate were noticed between group I and III. Preoperative TMCs in group I and III was 15.2 ± 1.2, 7.8 ± 1.4, respectively (p < 0.05). Postoperative TMCs in group I and III was 33.7 ± 2.5, 25.2 ± 1.9, respectively (p < 0.05). An overall spontaneous pregnancy rate of 34.4% was achieved after inguinal varicocelectomy. The greatest spontaneous pregnancy rate was achieved in Group I (37.3%), and the lowest pregnancy rate in Group III (26.3%) (P < 0.05). Conclusions: Surgical varicocelectomy improves the total sperm motility counts especially in patients who have a TMCS more than 5 million and improves the spontaneous pregnancy rates. The improvement in the spontaneous pregnancy rates after varicocelectomy correlates negatively with the duration of infertility. Therefore, duration of infertility should be considered in treating a patient with a varicocele as a cause of infertility.

The duration of infertility affects semen parameters in primary infertile men: results of a single‐centre, cross‐sectional study

“…Moreover, the DI period was the unique independent factor for the achievement of pregnancy after adjusting for male and female age and varicocoele grade . Similar results were found in a cohort of 183 patients who underwent varicocoelectomy and were divided into three groups (1–3, 4–6, >6 years) according to DI .…”

“…A limited number of studies have explored the association between DI and semen parameters. In particular, previous authors found that the DI correlates negatively with the improvement in the total sperm count and spontaneous pregnancy rates after varicocoelectomy . However, the relation between DI and fertility status is rather bi‐univocal: it is plausible that a longer DI will negatively affect male reproductive health, as well as lower fertility status will inevitably lead to longer DI.…”

Varicocele repair for infertility

“…According to the results of this study, the correction of varicocele aimed at restoring fertility could be more appropriate for men of couples with infertility longer than 2 years [19]. In a retrospective study analyzing 183 infertile patients with varicocele, Al-Ghazo et al [20] reported a spontaneous pregnancy rate higher in patients with an infertility duration shorter than 3 years (37.3%) in comparison with patients with longer infertility duration (34.9% for the infertility period ranging between 3 and 6 years; 26.3% for infertility longer than 6 years). ].…”

General Therapeutic Approach to Male Infertility

“…The longer the period, the lower is the residual fertility (ie, possibility to conceive naturally), even in the case of a correct therapeutic approach and an increase in sperm count [ 44 ].…”