Prediction of reproductive function recovery after microsurgical varicocelectomy in men from infertile couples: Clinical and laboratory predictors

Abstract

The objective was to reveal predictors for fertility recovery after varicocelectomy in subfertile men. This retrospective study recruited 93 men with clinical varicocele and pathozoospermia who underwent microsurgical varicocelectomy. Stepwise discriminant analysis was performed to identify predictors of spontaneous pregnancy (SP) after surgery. ‘Clinically significant improvement’ (CSI) following varicocelectomy was defined as an increase in total progressively motile sperm count (TPMSC) by at least 12.5 million (calculated from WHO‐2010 reference values). 52% of patients showed CSI, and 28% reported SP after surgery. Patients who reported SP (group II), compared to that remained infertile (group I), were younger (27.3 ± 2.9 versus 30.2 ± 4.2 years; p < .01), had less infertility period (24.1 ± 14.0 versus 44.4 ± 32.9 months; p < .05) and had initially higher TPMSC (median (25% −75%) = 34 (11–67) versus 9.5 (0–33) mln; p < .05). The stepwise discriminant analysis showed that male age (coefficient value = −0.157), total sperm motility (0.024) and postoperative increase in TPMSC (0.010) were the significant predictors of SP. The predictive ability, sensitivity and specificity of the discriminant function were 84%, 87%, 76% respectively. This algorithm can be recommended after varicocelectomy in decision‐making on natural conception or the ART protocols usage.

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

“…Concerning pregnancies after varicocelectomy, most authors agree that an initial high TMSC leads to a higher chance of conception. 23 , 24 The same situation holds for sperm concentration. Different authors proposed different initial values of the sperm concentration (from 2 × 10 6 ml -1 to 20 × 10 6 ml −1 ) as a marker of varicocelectomy success.…”

Nomogram for Predicting Spontaneous Pregnancy after Microscopic Varicocelectomy in Infertile Men with Normal Hormone

“…Another critical predictor for fertility recovery is the increase of TPMSC post MSV. Shomarufov et al, [13] who conducted a retrospective study on 93 infertile men with varicocele and pathozoospermia who underwent MSV, also identi ed that postoperative increase in TPMSC were predictors of SP post surgery. Furthermore, they found that 50% of the treated patients had an increase in TPMSC by 12.5 million.…”

“…Shomarufov et al conducted a retrospective study on 93 infertile men with varicocele and pathozoospermia who underwent MSV. They identi ed age, initial total sperm motility, and postoperative increase in total progressively motile sperm count (TPMSC) as predictors of SP post-surgery [13]. Another retrospective study included 176 infertile patients treated with subinguinal MSV.…”

Nomogram for predicting spontaneous pregnancy after microscopic varicocelectomy in infertile men with normal hormone

“…Another critical predictor for fertility recovery is the increase of TPMSC post MSV. Shomarufov et al, [ 14 ] who conducted a retrospective study on 93 infertile men with varicocele and pathozoospermia who underwent MSV, also identified that postoperative increase in TPMSC were predictors of SP post surgery. Furthermore, they found that 50% of the treated patients had an increase in TPMSC by 12.5 million.…”

“…Shomarufov et al conducted a retrospective study on 93 infertile men with varicocele and pathozoospermia who underwent MSV. They identified age, initial total sperm motility, and postoperative increase in total progressively motile sperm count (TPMSC) as predictors of SP post-surgery [ 14 ]. Another retrospective study included 176 infertile patients treated with subinguinal MSV.…”