Smoking and obesity negatively affect the favourable outcome of varicocelectomy in sub‐fertile men

Abstract

We assessed the effect of smoking and/or obesity on semen parameters and testosterone/oestradiol (T/E) ratio among sub‐fertile men treated with sub‐inguinal varicocelectomy. In this prospective, controlled, clinical study, 80 sub‐fertile men with clinical varicocele who were subjected to sub‐inguinal varicocelectomy were assigned into four equal groups (n = 20/each), group A: obese and smokers, group B: obese and nonsmokers, group C: smokers and nonobese and group D: nonsmokers and nonobese. Semen parameters, serum testosterone, oestradiol, follicle‐stimulating hormone, luteinising hormone, prolactin and calculation of T/E ratio were assessed at baseline and 6 months post‐varicocelectomy. The mean age ± SD of the study population was 26.1 ± 4.55. No statistical difference was detected among the study groups regarding age, residence, education, marital status and occupation (p > 0.05 for each). Post‐operatively, significant improvements in semen parameters were detected in all groups. There was a significant difference between groups A and B versus C and D (obese versus nonobese groups) and between groups A and C versus B and D (smokers versus nonsmokers; p < 0.05 for each) regarding semen parameters, testosterone level and T/E ratio. Smoking and/or obesity negatively affect(s) the favourable outcome of varicocelectomy, specifically improvement of semen parameters and hormonal pattern in sub‐fertile men with varicocele.

Does an increase in adipose tissue ‘weight’ affect male fertility? A systematic review and meta‐analysis based on semen analysis performed using the WHO 2010 criteria

“…showed that both obesity and varicocele are associated with a significant increase in 24‐h mean scrotal temperature when compared to controls. In addition, other authors have reported that obesity negatively affects varicocelectomy outcomes 102 . The latter evidence supports the additive effect of varicocele and obesity on male sperm quality as observed in our study.…”

“…In addition, other authors have reported that obesity negatively affects varicocelectomy outcomes. 102 The latter evidence supports the additive effect of varicocele and obesity on male sperm quality as observed in our study.…”

Varicoceles in Men With Non-obstructive Azoospermia: The Dilemma to Operate or Not

“…Thus, in a subpopulation of azoospermic males who demonstrated the appearance of spermatozoa in the ejaculate post-varicocele repair, the probability that another harmful contributing factor had been additionally removed/neutralized cannot be ruled out. In fact, several studies indicate the importance of discovering additional pathophysiologies to the varicocele pathophysiology that contribute to a certain degree to the phenotype of progressive testicular damage in NOA-males with varicoceles (i.e., among other contributing factors, the literature discusses the importance of smoking and obesity) ( 79 , 80 ).…”

A Systematic Review of the Relationship between Risk of Varicoceles and Obesity

“…Men without varicoceles [6] Case study NA 1093 2120 [9] Case study NA 490 560 [10] Case study NA 20 20 [11] Case study NA 98 NA [12] Case study NA 330 767 [13] Case study NA 40 40 [14] Prospective study South Korea 320 1618 [15] Cross-sectional study Bulgaria 255 5945 [16] Retrospective study Austria 1111 NA [17] Case study NA 77 NA [18] Case study NA 35 NA [19] Retrospective study South Korea 211 102 [20] Cross-sectional study Iran 167 NA [21] Retrospective-comparative study NA 587 1255 [22] Retrospective cohort study NA 147 NA [23] Case-control study NA 153 250 [24] Retrospective study NA 193 NA [25] NA NA 102 95 [26] Case study NA 200 200 [27] Retrospective study Turkey 85 1424 [28] Case study NA 298 577 [29] Retrospective study USA 114 NA [30] Cross-sectional study China 1911 37648 [31] Prospective study NA 138 117 [32] Retrospective study NA 398 1708 [33] Retrospective study NA 143 50 [34] Retrospective study Turkey 498 2061 [35] Retrospective [20].…”