The impact of ipsilateral testicular atrophy on semen quality and sperm DNA fragmentation response to varicocele repair

Kavoussi, Parviz K.; Abdullah, Natasha; Gilkey, Melissa S.; Hunn, Caitlin; Machen, G. Luke; Chen, Shu-Hung; Kavoussi, Keikhosrow M.; Esqueda, Amy S.; Wininger, J. David; Kavoussi, Shahryar K.

doi:10.4103/aja.aja_50_20

Cited by 7 publications

(4 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Finally, 29 studies assessing the impact of VR on SDF and MDA were included in the present analysis ( Fig. 1 ) [ 34 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 ].…”

Section: Resultsmentioning

confidence: 99%

Effects of Varicocele Repair on Sperm DNA Fragmentation and Seminal Malondialdehyde Levels in Infertile Men with Clinical Varicocele: A Systematic Review and Meta-Analysis

Cannarella,

Shah,

Saleh

et al. 2024

World J Mens Health

View full text Add to dashboard Cite

Purpose Varicoceles can be a source of elevated seminal oxidative stress (OS) and sperm DNA fragmentation (SDF). However, it remains unclear whether varicocele repair (VR) could reduce these parameters. This systematic review and meta-analysis (SRMA) aims to investigate the impact of VR on SDF and seminal malondialdehyde (MDA). Materials and Methods A literature search was performed in Scopus, PubMed, Ovid, Embase, and Cochrane databases. This SRMA included randomized controlled trials and observational studies reporting the pre- and postoperative levels of SDF and seminal OS in infertile men with clinical varicocele that underwent VR. Subgroup analyses included techniques of VR and SDF testing. The effect size was expressed as standardized mean difference (SMD). Results Out of 1,632 abstracts assessed for eligibility, 29 studies with 1,491 infertile men were included. The analysis showed a significant reduction in SDF after VR, compared to preoperative values (SMD −1.125, 95% confidence interval [CI] −1.410, −0.840; p<0.0001) with high inter-study heterogeneity (I 2 =90.965%). Reduction in SDF was evident with microsurgical technique and non-microsurgical inguinal approaches (SMD −1.014, 95% CI −1.263, −0.765; p<0.0001, and SMD −1.495, 95% CI −2.116, −0.873; p<0.0001), respectively. Reduction in SDF was significant irrespective of testing was done by sperm chromatin dispersion (SMD −2.197, 95% CI −3.187, −1.207; p<0.0001), sperm chromatin structure assay (SMD −0.857, 95% CI −1.156, −0.559; p<0.0001) or TUNEL (SMD −1.599, 95% CI −2.478, −0.719; p<0.0001). A significant decrease in seminal MDA levels was observed following VR (SMD −2.450, 95% CI −3.903 to −0.997, p=0.001) with high inter-study heterogeneity (I 2 =93.7%). Conclusions Using pre- and post-intervention data, this SRMA indicates a significant reduction in SDF and seminal MDA levels in infertile men with clinical varicocele treated with VR. These findings may have important implications for the future management of this selected group of infertile patients.

show abstract

Section: Resultsmentioning

confidence: 99%

Effects of Varicocele Repair on Sperm DNA Fragmentation and Seminal Malondialdehyde Levels in Infertile Men with Clinical Varicocele: A Systematic Review and Meta-Analysis

Cannarella,

Shah,

Saleh

et al. 2024

World J Mens Health

View full text Add to dashboard Cite

show abstract

“…The data show that 50% of recurrent miscarriage causes still cannot be shown, among which the male factor is an important aspect. Current studies have made it clearer that the main causes of male factors include severe sperm deformity, sperm DNA damage, and men's own chromosome abnormality 23 . Although some patients are still unable to determine the cause after a series of tests, studies suggest that avoiding certain adverse factors can benefit some patients, access to fertility.…”

Section: Male Factorsmentioning

confidence: 99%

“…Current studies have made it clearer that the main causes of male factors include severe sperm deformity, sperm DNA damage, and men's own chromosome abnormality. 23 Although some patients are still unable to determine the cause after a series of tests, studies suggest that avoiding certain adverse factors can benefit some patients, access to fertility. The direct causes of these sperm quality problems are varicocele, sperm membrane lipid peroxidation, and abnormal oxidative stress.…”

Section: Male Factorsmentioning

confidence: 99%

Recent Advances in Treatment of Recurrent Spontaneous Abortion

Deng

Liao

Zhu

2022

Obstetrical &Amp; Gynecological Survey

View full text Add to dashboard Cite

Importance Recurrent spontaneous abortion (RSA) is a distressing condition experienced by approximately 1% of women trying to conceive. However, the treatment of RSA is a challenge both for clinicians and patients. Objective The aim of this review is to discuss the medical and surgical approach to the management of RSA, including those caused by anatomical, genetic, male, infectious, endocrine, and immune factors. Evidence Acquisition A literature search using MeSH terms for each topic was undertaken using PubMed, supplemented by hand searching for additional references. Retrieved articles were reviewed, synthesized, and summarized. Results Available treatments target hypothetical risk factors for RSA, although the effectiveness of many treatment options is controversial. Intervention should depend on the benefit-to-risk ratio of the proposed treatment. Conclusions and Relevance The etiology of RSA is heterogeneous, and patients often lack specific clinical manifestations, which has hindered the progress in predicting and preventing RSA to some extent. Despite intensive workup, at least 50% of couples do not have a clear underlying pathology. In addition, an evidence-based treatment is not available in most patients even if abnormal test results are present. Many new treatment directions are also still actively exploring; empirical and combined multiple treatments are still the main methods. Target Audience Obstetricians and gynecologists, family physicians. Learning Objectives After completing this activity, the learner should be better able to describe common risk factors for RSA; formulate individualized treatment plans to improve pregnancy outcomes; and propose supportive treatment recommendations for patients with unclear causes.

show abstract

“…The indications for varicocelectomy in infertile patients are still debated. Some studies have shown improvements in semen quality, DNA fragmentation, and pregnancy rates after varicocele repair ( 8 , 9 ). However, other clinical investigations have reported unsatisfactory outcomes in infertile patients ( 10 , 11 ).…”

Section: Introductionmentioning

confidence: 99%

The role of testicular stiffness derived from shear wave elastography in the assessment of spermatogenesis in men with varicocele

Fu,

Cui,

Tang

2024

Quant Imaging Med Surg

View full text Add to dashboard Cite

Background Varicocele is a major correctable cause of male infertility. Shear wave elastography (SWE) represents a valuable approach for assessing spermatogenesis in infertile men; however, its application in infertile men with varicocele remains unreported in the literature to date. The objective of this study was to investigate the correlation between testicular stiffness and spermatogenesis in individuals with varicocele. Methods A total of 568 participants with left-side varicocele and 475 age-matched healthy controls were enrolled. The mean, left, and right testicular volumes (Volume-mean, Volume-L, and Volume-R), the mean elastic modulus of bilateral, left, and right testes (Emean, Emean-L, and Emean-R); the maximum elastic modulus of bilateral, left, and right testes (Emax, Emax-L, and Emax-R); the minimum elastic modulus of bilateral, left, and right testes (Emin, Emin-L, and Emin-R) were calculated. Results Receiver operating characteristic (ROC) curves for Volume-R and Emax were constructed to identify participants with sperm concentrations below 5 million/mL. The areas under the ROC curves (AUCs) were 0.801 and 0.775, respectively. Combining these 2 markers improved their diagnostic value with an AUC of 0.820 and sensitivity and specificity of 94.6% and 59.8% [95% confidence interval (CI): 0.772–0.867, P<0.01], respectively. A total of 69 participants underwent microsurgical varicocelectomy (including 42 cases with improved semen results and 27 without). The ROC curves of Emax-L and Volume-L were constructed for the differential diagnosis between the improved and unimproved groups; the AUCs were 0.723 and 0.855, respectively. Combining these 2 markers improved their diagnostic value with an AUC of 0.867 (95% CI: 0.772–0.961, P<0.01) and sensitivity and specificity of 81.5% and 81.0%, respectively. Conclusions Our findings suggest that SWE can be used for varicocele to assess testicular parenchyma damage and Volume-L combined with Emax-L offers a more accurate method for predicting semen parameter improvement after microscopic subinguinal varicocelectomy in men with varicocele.

show abstract

The impact of ipsilateral testicular atrophy on semen quality and sperm DNA fragmentation response to varicocele repair

Cited by 7 publications

References 28 publications

Effects of Varicocele Repair on Sperm DNA Fragmentation and Seminal Malondialdehyde Levels in Infertile Men with Clinical Varicocele: A Systematic Review and Meta-Analysis

Effects of Varicocele Repair on Sperm DNA Fragmentation and Seminal Malondialdehyde Levels in Infertile Men with Clinical Varicocele: A Systematic Review and Meta-Analysis

Recent Advances in Treatment of Recurrent Spontaneous Abortion

The role of testicular stiffness derived from shear wave elastography in the assessment of spermatogenesis in men with varicocele

Contact Info

Product

Resources

About