The role of varicocele treatment in the management of non-obstructive azoospermia

İnci, Kubilay; Günay, Murat

doi:10.6061/clinics/2013(sup01)10

Cited by 31 publications

(24 citation statements)

References 78 publications

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“…It has a prevalence of 15 -20% in the general population and 40% among infertile men (Will et al, 2011;Shiraishi et al, 2012;Inci & Gunay, 2013). It also causes progressive deterioration of seminal parameters (Will et al, 2011).…”

Section: Introductionmentioning

confidence: 98%

“…It also causes progressive deterioration of seminal parameters (Will et al, 2011). Although different mechanisms including increased scrotal temperature, oxidative stress, and hypoxia; refl ux of adrenal hormones and gonadotoxic metabolites; and autoimmunity have been proposed to explain the pathophysiology of infertility caused by varicocele, the question is still under debate (Ferlin et al, 2010;Will et al, 2011;Inci & Gunay, 2013).…”

Section: Introductionmentioning

confidence: 98%

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Seminal insulin-like growth factor-I may be involved in the pathophysiology of infertility among patients with clinical varicocele

et al. 2014

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Varicocele, the most common cause of male infertility, is defined as abnormal dilation of the pampiniform plexus. Although different mechanisms have been proposed to explain the pathophysiology of infertility caused by varicocele, it is still open to debate. Previous studies have demonstrated the effect of insulin-like growth factor-I (IGF-I) on semen quality in animals and humans, but there are no studies on the probable role of seminal IGF-I in the pathophysiology of infertility among patients with clinical varicocele. We therefore aimed to examine the seminal IGF-I concentration in 49 patients with varicocele and primary infertility before and after varicocelectomy and compare the results with those of 50 healthy fertile men (in the control group). Mean seminal IGF-I level of patients before varicocelectomy (93.7 ± 67.2 ng/mL) was significantly different (P < 0.001) from that following varicocelectomy (58 ± 35.1 ng/mL) and from that of the controls (57.6 ± 22.1 ng/mL). However, mean seminal IGF-I levels of patients after varicocelectomy and the controls were not significantly different. Seminal IGF-I level was not correlated with grade and side of varicocele, and semen quality. We conclude that locally secreted IGF-I in the semen may be involved in the pathophysiology of infertility in patients with varicocele or semen.

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Section: Introductionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 98%

Seminal insulin-like growth factor-I may be involved in the pathophysiology of infertility among patients with clinical varicocele

et al. 2014

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“…2 Varicoceles that are diag� nosed primarily via physical examination are referred to as clinical varicoceles, whereas those that are <3 mm in diam� eter and observed only via colour Doppler ultrasonography (CDU) with the Valsalva maneuver are considered subclini� cal varicoceles. 3 Varicoceles are associated with other vas� cular pathologies. 4 Kılıç and colleagues also reported that peripheral varicose veins share a pathological mechanism with varicocele.…”

Section: Introductionmentioning

confidence: 99%

Does varicocele correction lead to normalization of preoperatively elevated mean platelet volume levels?

Çoban

Ibrahim

Bıyık

et al. 2015

CUAJ

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Introduction: There are several studies on the relationship between increased mean platelet volume (MPV) and varicocele. �e inves� �e inves� tigated the relationship between preoperative and 6�month post� operative MPV values in patients whose varicocele was corrected with surgery. Methods: A total of 282 patients underwent surgery at our urology clinic between December 2011 and December 2013 for primary varicocele. �e retrospectively examined the records of 61 patients who came to the 6�month postoperative follow�up. The preop� erative varicocele diagnosis was made with physical examination findings and supported with colour Doppler ultrasonography. Results: The varicocele was grade I in 12 patients, grade II in 34 patients and grade III in 11 patients. �hen the preoperative and 6�month postoperative haemoglobin (Hb), MPV, mean corpuscular volume, platelet, and platelet distribution width (PD�) values were compared, there was a significant decrease in MPV (p = 0.019), and a significant increase in Hb (p < 0.001). A noticeable increase was also present in PD�, but it was not statistically significant (p = 0.058). Conclusion: �e found that MPV increased in patients with varic� ocele and tended to decrease again after the varicocele was sur� gically corrected. However, we feel larger prospective series are needed.

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“…On the other hand, Schlegel et al found that men with NOA associated with clinical varicocele rarely had adequate amounts of sperm in the ejaculate after undergoing varicocelectomy to an attempt to avoid TESE [63]. Table 3 shows the outcomes of varicocelectomy in men with NOA in previous studies [61,[64][65][66][67][68][69][70][71][72][73][74][75][76][77][78]. These findings indicate that a certain percentage of men with NOA and varicocele successfully recovered sperm in the ejaculate after varicocelectomy, and the recovery of sperm appears to be dependent on testicular histology.…”

Section: Varicocele Repair Before Tesementioning

confidence: 99%

The development of surgical sperm extraction and new challenges to improve the outcome

Enatsu

Chiba

Fujisawa

2015

Reprod Medicine & Biology

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Surgical sperm extraction with intracytoplasmic sperm injection has become widespread worldwide and is regarded as the sole option for patients with azoospermia. However, the sperm retrieval rate remains unsatisfactorily low, particularly for men with non-obstructive azoospermia (NOA). Therefore, the technical challenges associated with improving the sperm retrieval rate for men with NOA are being addressed. The most successful method developed to date is microdissection testicular sperm extraction (micro-TESE), which is rapidly becoming recognized as a useful technique due to its relatively high sperm retrieval rate and low complication rate. However, even with micro-TESE, the sperm retrieval rate for men with NOA remains at 30-60 %, with an even lower birth rate. The technical challenges associated with improving the outcomes of surgical sperm extraction are being approached through the use of ultrasound and optimal surgical devices such as narrow band imaging, multiphoton microscopy, and optical coherent tomography. In addition to the difficulties related to searching for sperm, medical treatments that induce spermatogenesis remain controversial. For example, varicocele repair prior to surgical sperm extraction and hormonal therapy before and after TESE have been extensively examined. We herein briefly summarized the development process in surgical sperm extraction up to the present and technical challenges to improve the outcomes of surgical sperm extraction.

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The role of varicocele treatment in the management of non-obstructive azoospermia

Cited by 31 publications

References 78 publications

Seminal insulin-like growth factor-I may be involved in the pathophysiology of infertility among patients with clinical varicocele

Seminal insulin-like growth factor-I may be involved in the pathophysiology of infertility among patients with clinical varicocele

Does varicocele correction lead to normalization of preoperatively elevated mean platelet volume levels?

The development of surgical sperm extraction and new challenges to improve the outcome

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