Induction of spermatogenesis in azoospermic men after varicocele repair

Pasqualotto, Fábio Firmbach; Lucon, Antônio Marmo; Hallak, Jaime Eduardo Cecílio; Góes, Patrícia Freitas; Saldanha, Luiz Balthazar; Arap, Sami

doi:10.1093/humrep/deg032

Cited by 62 publications

(51 citation statements)

References 26 publications

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“…In fact, varicocelectomy has become the most commonly performed operation in male infertility (1,2,22,24-26). However, couples have to be counseled that they will have to wait for at least 12 months following varicocelectomy before deciding to proceed with any type of assisted reproductive technique (ART) (27,28).…”

Section: Discussionmentioning

confidence: 99%

Is it worthwhile to operate on subclinical right varicocele in patients with grade II–III varicocele in the left testicle?

Pasqualotto

Lucon

Góes

et al. 2005

J Assist Reprod Genet

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Purpose : To determine whether repair of subclinical varicoceles in the right testicle results in significant seminal improvement in patients with clinical left varicocele. Methods : Patients were divided into two groups: Group I (unilateral varicocelectomy) and Group II (bilateral varicocelectomy-subclinical left varicocele). The mean sperm concentration before treatment was higher in Group I (21.01 ± 19.1) compared to Group II (5.7 ± 10.7) (p = 0.04). Results : An increase in volume was detected in the left testicle of patients in Group I (17 ± 7.9 vs. 22.81 ± 8.2; p = 0.04) and in the right testicle of patients in Group II (18.4 ± 6.2 vs. 22.3 ± 6.5; p = 0.04). Although the mean postoperative sperm concentration in Group I increased slightly (25.7 ± 22.8), the mean sperm concentration in Group II increased significantly (30.32 ± 9.8; p = 0.03). Pregnancy rate was higher in Group II (66.7%) compared to Group I (33.3%). Conclusions : Even a small, subclinical unrepaired varicocele continues to have a detrimental effect on bilateral testis function in a patient with grade II-III left varicocele.

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Section: Discussionmentioning

confidence: 99%

Is it worthwhile to operate on subclinical right varicocele in patients with grade II–III varicocele in the left testicle?

Pasqualotto

Lucon

Góes

et al. 2005

J Assist Reprod Genet

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“…The left varicocele was induced as previously reported [Pasqualotto et al 2003]. Briefly, the animals were anaesthetized with intra-peritoneal injection of 7mg/kg ketamine hydrochloride 5% (Trittau, Germany) and 5mg/kg xylazine 2% (Woerden, The Netherlands).…”

Section: Varicocele Inductionmentioning

confidence: 99%

Silymarin protects from varicocele-induced damages in testis and improves sperm quality: evidence for E2f1 involvement

Moshtaghion¹,

Malekinejad²,

Razi

et al. 2013

Systems Biology in Reproductive Medicine

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This study was designed to evaluate the protective effect of silymarin (SMN) on varicocele-induced damage in testis and its effects on sperm parameters and on antioxidant status. Wistar rats were divided into three groups: control-sham, varicocele-induced, and SMN-treated varicocelized (50mg/kg, orally) rats. The sperm count, DNA integrity, and histone-protamine transition was evaluated after 42 days. The antioxidant status was analyzed by determining testicular malondialdehyde (MDA) and total thiol molecules (TTM). The endocrine status of the testicular tissue was estimated by counting the normal Leydig cell distribution/mm 2 and by determination of serum testosterone. The expression of E2f1 mRNA was analyzed using RT-PCR. Carbohydrate depletion and lipid foci replacement in germinal cells were examined by histochemical analyses. Silymarin rehabilitated the varicocele-induced Leydig cell degeneration and testosterone reduction. In addition, SMN recovered the varicocele-induced reduction of TTM and lowered significantly (P < 0.05) the varicocele-elevated content of MDA. The SMN treatment resulted in a significant (P < 0.05) down-regulation of the VCL-up-regulated E2f1 mRNA. Silymarin-treated animals were protected from varicoceleinduced testicular atrophy and these animals showed a significant (P < 0.05) increase in the percentage of seminiferous tubules with positive tubular differentiation, repopulation, and spermiogenesis indices. Furthermore, SMN improved the varicocele-induced carbohydrate reduction in germinal cells. Our data suggest that in addition to oxidative stress, alteration in the testicular endocrine function plays a crucial role in the pathogenesis of varicocele. Moreover, the protective effects of SMN on varicocele-induced damage may reflect its antioxidant property, which may be mediated via the E2f1 transcription factor.

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“…Varicocele (dilatation of the testicular veins) seems to disrupt the heat exchange mechanism and may induce infertility. Ligation of the dilated veins improves sperm quality (Matthews et al 1998, Pasqualotto et al 2003. Long-term cooling of the testes is reported to increase sperm quality in selected, infertile men.…”

Section: Transfer From Testis To Testis and To Epididymismentioning

confidence: 99%

Counter-current transfer in reproductive biology

Einer‐Jensen

Hunter²

2005

Reproduction

104

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Heat and substances, including gases, steroids and peptide hormones, can pass from venous blood, interstitial fluid and lymph to the arterial blood; the process is called local counter-current transfer. It has been found in various reproductive organs in many animal species and in man: from the testis to the testis and epididymis; from the ovary to the ovary, tube and tubal corner of the uterus; from the tube and uterus to the ovary; from vagina to uterus; and even between brain blood vessels. Local transfer within the ovary has also been found. Local cooling that creates temperature gradients between organs or within an organ is one aspect of the transfer. Physiologically, the transfer also facilitates local feedback regulation of organ function in a process situated between general distribution of hormones through the systemic circulation and paracrine regulation. Counter-current transfer of drugs after local application opens up new possibilities for treatment.

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Induction of spermatogenesis in azoospermic men after varicocele repair

Abstract: Azoospermic patients may have an improvement in semen quality following varicocelectomy. Semen samples should be cryopreserved after an initial improvement following varicocelectomy, as relapse to a state of azoospermia may occur.

Cited by 62 publications

References 26 publications

Is it worthwhile to operate on subclinical right varicocele in patients with grade II–III varicocele in the left testicle?

Is it worthwhile to operate on subclinical right varicocele in patients with grade II–III varicocele in the left testicle?

Silymarin protects from varicocele-induced damages in testis and improves sperm quality: evidence for E2f1 involvement

Counter-current transfer in reproductive biology

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