The Clinical Outcomes of Varicocelectomy and Assisted Reproductive Technology to Treat Men Infertility: A Meta-Analysis

Abstract

The current study aimed to evaluate the effects of varicocelectomy on semen quality and Assisted Reproductive Technology (ART) clinical outcomes. This meta-analysis was performed using Ovid (Medline, Adis, LWW, Embase; 1974 to 2014 November 10) and the PubMed (until 2014 November 10) databases. Male infertility, varicocelectomy and assisted reproductive technology were required as keywords. Data were analysed with STATA 11.0. Odds Ratio (OR) and 95% Confidence Interval (CI) were used to assess the effects of varicocelectomy on the ART clinical outcomes and funnel plots help to detect publication bias. 538 of 1068 participants issue from 7 original sources from diverse area in the world underwent varicocelectomy followed by ART between 2001 and 2011. Globally, defected semen parameters were improved after varicocelectomy among treated groups in all these studies. Significant improvement in clinical pregnancy (OR=1.76; 95% CI: 1.35-2.29, P<0.0001) and decrease of miscarriage rate (OR=0.65; 95% CI: 0.42-0.99, P=0.042) after ART use-among treated group; and finally, undergo ART specifically Intracytoplasmic Sperm Injection (ICSI) after varicocelectomy may increase live birth among treated group; Although 4 of these studies showed statistical differences, overall, there is no difference to achieve pregnancy among couples who underwent varicocelectomy and followed ART (OR=1.58; 95% CI: 0.82-3.03; P=0.172). Overall, the findings of the study suggested that varicocelectomy improves semen quality and therefore may reduce miscarriages, increase clinical pregnancy and live birth rates of couples who undergo ART specifically ICSI.