Determination of the time for improvement in semen parameters after varicocelectomy

Pazır, Yaşar; Erdem, Selçuk; Çilesiz, Nusret Can; Kadıoğlu, Ateş

doi:10.1111/and.13895

Cited by 5 publications

(3 citation statements)

References 25 publications

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“…Overall, our median follow-up from surgery to patients’ last postoperative SA was 6.6 months, which provides adequate time for semen parameters to improve or change after varicocelectomy. Prior studies show that among patients with preoperative TMSC <5M (IVF) and preoperative TMSC 5-9M (IUI), postoperative TMSC does not improve past the third and sixth month, respectively [ 16 ]. Similarly, in a study of 170 men, 118 of whom experienced a 50% or greater improvement in their TMSC after varicocelectomy, only five (2.9%) experienced this improvement >6 months after their procedure [ 17 ].…”

Section: Discussionmentioning

confidence: 99%

Predictors of Semen Parameters Decline Following the Microsurgical Varicocelectomy

Greenberg,

Hudnall,

Goyette

et al. 2023

Cureus

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Objective Varicocele is considered the most common reversible cause of male infertility. However, some men do not clinically improve after surgical repair. We aimed to identify preoperative factors associated with decreased semen parameters and clinical “downgrading” of total motile sperm count (TMSC) following varicocelectomy. Methods We examined men with preoperative laboratory testing and pre- and postoperative semen analyses (SA) who underwent varicocelectomy between 2010 and 2020. Ejaculate volume, sperm motility, sperm concentration, TMSC, and clinical grade of TMSC (in vitro fertilization: <5M sperm, intrauterine insemination: 5-9M sperm, natural pregnancy: >9M sperm) were used to determine postoperative outcomes. Demographic and clinical factors were compared between cohorts. Results Among 101 men who underwent varicocelectomy, 35 (34.7%) had decreased postoperative TMSC with a median follow-up of 6.6 months (interquartile range 3.9-13.6 months). Eleven (10.9%) men experienced TMSC clinical “downgrading” following surgery. Clinical grade III varicocele was significantly associated with decreased sperm motility on postoperative SA (OR 4.1, 95% CI 1.7-10.0, p=0.002), and larger left testicle volume (OR 1.4, 95% CI 1.1-1.8, p=0.02) was associated with clinical “downgrading” after varicocelectomy. Conclusion A small but significant proportion of men experienced a “downgrading” of semen parameters after varicocelectomy. Larger left testis size was associated with clinical downgrading, whereas clinical grade III varicoceles were associated with lower post-treatment sperm motility. These data are critical for preoperative patient counseling.

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Section: Discussionmentioning

confidence: 99%

Predictors of Semen Parameters Decline Following the Microsurgical Varicocelectomy

Greenberg,

Hudnall,

Goyette

et al. 2023

Cureus

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“…It is well known that varicocele repair significantly improves both natural and in vitro fertilization procedures and live birth and pregnancy rates, as well as sperm count, total and progressive motility, morphology, and DNA fragmentation rates. In general, after varicocelectomy, up to 70% of patients have improved sperm quality, with an average of a minimum of two spermatogenic cycles [4] and spontaneous pregnancy occurring between 6 and 12 months [5]. However, the degree of restoration of the seminal parameters and fertility after varicocelectomy is known to vary according to the ages of patients.…”

Section: Introductionmentioning

confidence: 99%

Positive Effects of a Resveratrol-Based Nutraceutical in Association with Surgical Scleroembolization: A Pilot Retrospective Clinical Trial

Italiano,

Ceccarelli,

Italiano

et al. 2024

JCM

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Background: Varicocele still today represents a common cause of infertility in young men. The treatment strategy remains a surgical approach such as scleroembolization; however, the complete restoration of spermatic parameters afterward requires an average of six or more months to fully regain optimal seminal parameters. Recently, many studies have demonstrated the beneficial effects of Resveratrol in male fertility, given its potential anti-inflammatory, antiapoptotic, and mitochondrial effects. Therefore, Resveratrol-based nutraceuticals could be promising as an adjuvant to mitigate subfertility in patients with varicocele. Methods: In the present study, we retrospectively analyzed the effects of the administration of a Resveratrol-based nutraceutical after the scleroembolization procedure. The improvement of sperm quality in terms of number, motility, and morphology were considered to be the study’s main endpoints. A spreadsheet program was used for data analysis, and a p-value of <0.05 was considered significant. Results: We found a statistically significant improvement in the spermatic parameters (sperm count and total motility) and an increase in normal sperm after only 4 months of treatment. The supplementation with a Resveratrol-based nutraceutical associated with the surgical procedure showed encouraging results if compared to data from a control group and the results reported in the literature linked to scleroembolization practice alone. In fact, there was a clear improvement in the seminal parameters at 4 months. Conclusions: This suggests the positive impact of the Resveratrol-based nutraceutical in synergizing with scleroembolization in reducing the time needed to fully recover sperm function.

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“…At the same time, varicocelectomy does not always lead to an improvement in sperm quality and fertility recovery: semen improvement after surgery usually occurs in 60%–70% of cases 11 , 12 and natural pregnancies occur in 25%–40% of couples. 11 , 13 , 14 …”

Section: Introductionmentioning

confidence: 99%

Predictors of microsurgical varicocelectomy efficacy in male infertility treatment: critical assessment and systematization

Shomarufov

Bozhedomov

Сорокин

et al. 2022

Asian Journal of Andrology

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In this review, we tried to systematize all the evidence (from PubMed [MEDLINE], Scopus, Cochrane Library, EBSCO, Embase, and Google Scholar) from 1993 to 2021 on the predictors of microsurgical varicocelectomy efficacy in male infertility treatment. Regarding the outcomes of varicocele repair, we considered semen improvement and pregnancy and analyzed them separately. Based on the 2011 Oxford CEBM Levels of Evidence, we assigned a score to each trial that studied the role of the predictor. We systematized the studied predictors based on the total points, which were, in turn, calculated based on the number and quality of studies that confirmed or rejected the studied predictor as significant, into three levels of significance: predictors of high, moderate, and low clinical significance. Preoperative total motile sperm count (TMSC) coupled with sperm concentration can be a significant predictor of semen improvement and pregnancy after varicocelectomy. In addition, for semen improvement alone, scrotal Doppler ultrasound (DUS) parameters, sperm DNA fragmentation index (DFI), and bilateral varicocelectomy are reliable predictors of microsurgical varicocelectomy efficacy.

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Determination of the time for improvement in semen parameters after varicocelectomy

Cited by 5 publications

References 25 publications

Predictors of Semen Parameters Decline Following the Microsurgical Varicocelectomy

Predictors of Semen Parameters Decline Following the Microsurgical Varicocelectomy

Positive Effects of a Resveratrol-Based Nutraceutical in Association with Surgical Scleroembolization: A Pilot Retrospective Clinical Trial

Predictors of microsurgical varicocelectomy efficacy in male infertility treatment: critical assessment and systematization

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