Does varicocelectomy affect DNA fragmentation in infertile patients?

Telli, Onur; Sarıcı, Haşmet; Kabar, Mucahit; Özgür, Berat Cem; Reşorlu, Berkan; Bozkurt, Selen

doi:10.4103/0970-1591.152811

Cited by 32 publications

(16 citation statements)

References 22 publications

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“…Varicocele is found in approximately 15% of fertile men and 19-41% of infertile patients. There are several pathways for varicocele-induced infertility ( 32 ). One of the main factors responsible for infertility or subfertility in patients with varicocele is sperm DNA damage.…”

Section: Introductionmentioning

confidence: 99%

“…Studies showed that there is a significant raise in abnormal sperm chromatin condensation in infertile men with varicocele that will noticeably improve following varicocelectomy ( 38 - 40 ). Werthman et al examined patients who had preoperative levels of >30% of sperm DNA fragmentation index and exhibited a subsequent significant decrease of the percent of DNA fragmentation index values after surgery ( 32 ). Ghanaie et al demonstrated that varicocele repair increases the chance of spontaneous pregnancies and live births ( 41 ).…”

Section: Introductionmentioning

confidence: 99%

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The etiologies of sperm DNA abnormalities in male infertility: An assessment and review

Pourmasumi¹,

Sabeti²,

Rahiminia³

et al. 2017

IJRM

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The sperm DNA damage may occur in testis, genital ducts, and also after ejaculation. Mechanisms altering chromatin remodeling are abortive apoptosis and oxidative stress resulting from reactive oxygen species. Three classifications of intratesticular, post-testicular, and external factors have been correlated with increased levels of human sperm DNA damage which can affect the potential of fertility. Lifestyle, environment, medical, and iatrogenic factors might be considered to cause dysmetabolism to make distracting interactions and endocrine disrupting compounds. As a result, these may induce chromatin/DNA alteration in germ cells, which may be transmitted across generations with phenotypic consequences. Alcohol consumption may not increase the rate of sperm residual histones and protamine deficiency; however, it causes an increase in the percentage of spermatozoa with DNA fragmentation and apoptosis. In a medical problem as spinal cord injury, poor semen parameters and sperm DNA damage were reported. Infection induces reactive oxygen species production, decreases the total antioxidant capacity and sperm DNA fragmentation or antigen production that lead to sperm dysfunctions and DNA fragmentation. While reactive oxygen species generation increases with age, oxidative stress may be responsible for the age-dependent sperm DNA damage. The exposing of reproductive organs in older men to oxidative stress for a long time may produce more DNA-damaged spermatozoa than youngers. Examining the sperm chromatin quality in testicular cancer and Hodgkin’s lymphoma patients prior to chemotherapy demonstrated the high incidence of DNA damage and low compaction in spermatozoa at the time of the diagnosis. In chemotherapy cycle with genotoxic agents in cancer patients, an increase in sperm DNA damage was shown after treatment. In overall, those factors occurring during the prenatal or the adult life alter the distribution of proteins associated with sperm chromatin induce changes in germ cells which can be detected in infertile patients.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The etiologies of sperm DNA abnormalities in male infertility: An assessment and review

Pourmasumi¹,

Sabeti²,

Rahiminia³

et al. 2017

IJRM

View full text Add to dashboard Cite

show abstract

“…It is important to consider these two groups both individually and as a whole given the proposed pathophysiology of infertility in men with varicocele. Specifically, VR has been shown to decrease the high sperm DNA fragmentation rates and reactive oxygen species associated with varicoceles, and this type of DNA damage has been associated with worse outcomes in ART treatments (10,(19)(20)(21). Although patients with oligospermia and nonobstructive azoospermia may represent a similar population along a continuum versus entirely unique populations, oxidative stress likely plays a role in each.…”

Section: Discussionmentioning

confidence: 99%

Undergoing varicocele repair before assisted reproduction improves pregnancy rate and live birth rate in azoospermic and oligospermic men with a varicocele: a systematic review and meta-analysis

Kirby

Wiener

Rajanahally

et al. 2016

Fertility and Sterility

142

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Oligospermic and azoospermic patients with clinical varicocele who undergo VR experience improved live birth rates and PRs with IVF or IVF/ICSI. For persistently azoospermic men after VR requiring TESE for IVF/ICSI, VR improves sperm retrieval rates. Therefore, VR should be considered to have substantial benefits for couples with a clinical varicocele even if oligospermia or azoospermia persists after repair and ART is required.

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“…The authors noted that semen parameters and DFI were improved 3 months after varicocelectomy. 30 A meta-analysis of 6 studies, including 177 patients with varicocele, evaluated the effect size of varicocelectomy on sperm DNA damage. The authors reported that varicocelectomy improve sperm DNA integrity with a mean difference of −3.37% (95% CI: −4.09–−2.65).…”

Section: Varicocele Oxidative Stress and Sperm Dna Damagementioning

confidence: 99%

Summary evidence on the effects of varicocele treatment to improve natural fertility in subfertile men

Tiseo

Esteves

Cocuzza³

2016

Asian J Androl

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The objective of this review was to summarize the evidence concerning the benefit of varicocele treatment to improve natural fertility in subfertile males. We also analyzed the effect of varicocele treatment on conventional semen parameters and sperm functional tests. An electronic search to collect the data was performed using the PubMed/MEDLINE databases until July 2015. Data pooled from a variety of study designs indicate that varicocelectomy improves semen parameters in the majority of the treated men with clinical varicocele and abnormal semen parameters regardless of the chosen surgical method. Surgical varicocele repair was beneficial not only for alleviating oxidative stress-associated infertility but also to improve sperm nuclear DNA integrity. However, given the low magnitude of the effect size in sperm DNA integrity, further research is needed to elucidate its clinical significance. Conflicting results on the effect of varicocele treatment on natural fertility seem to be due to heterogeneous study designs and, more importantly, patient selection criteria. When these issues are controlled, current evidence indicates that treatment of subclinical varicocele is not warranted, as it does not seem to improve fertility. On the contrary, fair evidence indicates that varicocele treatment should be offered to infertile patients with palpable varicocele and abnormal semen parameters. This evidence supports the current guidelines issued by the American Urological Association and European Association of Urology, which state that varicocele treatment should be offered to male partners of infertile couples presenting for evaluation with clinical varicocele and semen parameters alterations.

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Does varicocelectomy affect DNA fragmentation in infertile patients?

Cited by 32 publications

References 22 publications

The etiologies of sperm DNA abnormalities in male infertility: An assessment and review

The etiologies of sperm DNA abnormalities in male infertility: An assessment and review

Undergoing varicocele repair before assisted reproduction improves pregnancy rate and live birth rate in azoospermic and oligospermic men with a varicocele: a systematic review and meta-analysis

Summary evidence on the effects of varicocele treatment to improve natural fertility in subfertile men

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