Results of Varicocelectomy in Patients with Isolated Teratozoospermia

Abstract

Introduction: Isolated teratozoospermia is rarely encountered in patients with clinically palpable varicocele, and the consequences of varicocelectomy remain unclear in these cases. In the current study, we assessed the effect of varicocelectomy on sperm morphology in a series of patients with infertility. Materials and Methods: The data obtained from 52 primary subfertile men with isolated teratozoospermia and clinical palpable varicocele were reviewed retrospectively. Varicocelectomy was performed on 29 patients, and the remaining 23 patients did not undergo any treatment (control group). The differences in sperm morphology assessed by using Kruger’s strict criteria 3 months before and 12 months after varicocelectomy were taken into consideration for statistical analysis. Results: One patient who underwent varicocelectomy was excluded from the study due to varicocele recurrence. Thus, data obtained from the remaining 28 patients were evaluated. Following varicocelectomy, significant improvement was detected in the ratio of normal sperm forms (p < 0.001). While there was significant improvement in the ratio of sperm cells with head defects, tail defects and immature forms (p < 0.001), the ratio of sperm with acrosome and mid-piece defects was not changed (p > 0.05). While an overall spontaneous pregnancy was achieved in 5 of the 28 (17.8%) couples in the varicocelectomy group within 12 months after operation, neither improvement in sperm morphology nor pregnancy in the patients’ partners was detected in the control group. Conclusion: Varicocelectomy caused a significant improvement in sperm morphology, particularly in immature forms and forms with head and tail defects evaluated by Kruger’s classification.

The great debate: varicocele treatment and impact on fertility

“…After stratification, men with normal sperm counts had no significant improvements in sperm parameters and 21% (10/46) became oligospermic afterwards 80. A separate report of subfertile men with isolated teratozoospermia and clinical varicocele by Cakan et al showed significant improvement in all sperm parameters and spontaneous pregnancy rate of 18% (5/29) after subinguinal repair in comparison to those who decided against surgery who had no improvements in semen analysis and no pregnancies (0/23) in the follow up period (12 months) 81. These results only further underline the need for controlled studies that have less confounding variables that may influence the significance of the data.…”

Effects of Varicocelectomy on Abnormal Semen Parameters in Patients with Clinically Palpable Varicocele

“…23 Murat Çakan et al found improvement of normal morphology after surgery and during the follow-up. 24 Barbalis et al also found improved semen morphology after varicocelectomy. 25 The present study showed that 9 among 45 patients had abnormal sperm morphology and their preoperative mean semen morphology was 1.0±1.2%.…”

Benefit of varicocelectomy in infertile men with varicocele

“…Cakan M et al studied impact of varicocelectomy on sperm morphology and found that sperm morphology improves following varicocelectomy. 20 Senbanjo RO et al, also showed that varicocelectomy results in improvement of semen quality in about 53% of patients. 21 Many studies have shown that varicocelectomy results in improvement of many semen parameters viz sperm count, sperm motility, sperm morphology and ultimately pregnancy rates.…”