The significance of gonadotropin-releasing hormone test for predicting fertility after varicocelectomy

Fujisawa, Masato; Hayashi, Akifumi; Imanishi, Osamu; Tanaka, Hirokazu; Okada, Hiroshi; Matsumoto, Osamu; Kamidono, Sadao

doi:10.1016/s0015-0282(16)56662-x

Cited by 30 publications

(9 citation statements)

References 6 publications

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“…Hudson performed free sex steroid levels in 64 infertile patients with varicocele and the men who had postoperative improvements in seminal parameters had improvements in free testosterone [6]. We performed high ligation before in 25 adolescents with varicoceles; sperm quality improved in 17 patients but we detected no significant differences in serum testosterone levels before and after surgery [4]. In the present study, sperm concentration and motility increased after treatment, but the differences are insignificant.…”

Section: Discussionmentioning

confidence: 43%

“…Endocrinological [2], low androgen level [14], and blunted testosterone response to hCG [5]. We also concluded before that the change of the LH response to the GnRH test postoperatively is a helpful method of predicting the outcome of the surgery because the pathology of varicocele patients may be related to some endocrine repercussions [4]. Sperm motility also improves significantly by the recovery of testosterone synthesis, essential for epididymal function, and the removal of the hyperthermic effects of the varicocele and the amelioration of epididymal function, resulting in testicular hypothermia [13].…”

Section: Discussionmentioning

confidence: 70%

“…To gain more insight into the effect of treatment of varicocele on spermatogenesis, more accurate markers would be useful. We have reported an exaggerated gonadotrophin response to gonadotropin releasing hormone (GnRH), which could be normalized by varicocele treatment, implying impairment of gonadotrophin control mechanisms in infertile men with varicocele [4].…”

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confidence: 99%

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Varicocele Ligation on Free Testosterone Levels in Infertile Men With Varicocele

Ishikawa¹,

Fujisawa²

2004

Archives of Andrology

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We have analyzed the effects of varicocele ligation on free testosterone levels, and investigated the interrelationships between free testosterone and fertility. The records were retrospectively evaluated for 42 infertile patients who underwent varicocele ligation, with serum free testosterone levels, follicle stimulating hormone (FSH), lutenizing hormone (LH), testosterone, estradiol, prolactin, ejaculated volume, sperm concentration and motility before and after surgery. Serum free testosterone levels increased from 12.97 AE 4.16 to 13.59 AE 3.93 pg=mL, but the difference was insignificant. The differences before and after surgery of patients in sperm concentration and motility were also insignificant. However, in free testosterone increasing group, the sperm concentration and motility increased significantly, from 4.05 AE 4.35 to 7.90 AE 8.19 million=mL (P ¼ 0.01) and from 30.64 AE 21.87% to 41.00 AE 22.00%, respectively (P ¼ 0.03). The increase in serum free testosterone level by varicocele ligation results in a significant improvement in sperm concentration and motility.

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Section: Discussionmentioning

confidence: 43%

Section: Discussionmentioning

confidence: 70%

mentioning

confidence: 99%

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Varicocele Ligation on Free Testosterone Levels in Infertile Men With Varicocele

Ishikawa¹,

Fujisawa²

2004

Archives of Andrology

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“…On one hand a study has indicated that varicocelectomy improved Sertoli cell and Leydig cell function increasing serum testosterone, and resulted in improvement in sperm concentration and motility [Su et al 1995]. On the other hand other groups have shown that there was no statistically significant change after the operation in levels in the semen of FSH, LH, and testosterone [Fujisawa et al 1994;Segenreich et al 1986]. As reported in the above we confirm the latter that there was no significant difference in these hormonal parameters among normal control and pre-and post-operative groups.…”

Section: Discussionmentioning

confidence: 99%

Significant improvement of sperm DNA quality after microsurgical repair of varicocele

Li¹,

Yamaguchi²,

Okada³

et al. 2012

Systems Biology in Reproductive Medicine

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Varicocele is currently the most common irregularity identified in males that is associated with impaired spermatogenesis. It primarily presents in the form of decreased sperm count and motility, abnormal morphology, and significantly increased sperm DNA fragmentation. Several studies have shown that surgical repair improves semen parameters and increases the odds of spontaneous pregnancy. However the exact effect of surgical repair treatment remains controversial. Therefore, the aim of our study was to evaluate the effectiveness of microsurgical repair by comparing common semen parameters and sperm DNA fragmentation index (DFI). We evaluated infertile men (n = 19) who underwent microsurgical subinguinal varicocelectomy for treatment of clinical varicocele before and 3 months after surgery. Normozoospermic men (n = 19) were considered as the normal control group. Semen parameters improved significantly after surgery when compared with that before surgery, but still significant differences with the normal control group were observed. In comparison, sperm DNA integrity improved significantly after surgery (percentage DFI decreased from 28.4 ± 15.6% before surgery to 22.4 ± 12.9%, at 3 months post surgery) to similar levels as the normal control group. These results suggest that microsurgical repair may be considered as a treatment option in infertile men with palpable varicocele.

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“…Bazı çalışmalarda, gonodotropin releasing hormon (GnRH) enjeksiyonu sonrasında varikoselli erkeklerin bir grubunda, artmış LH ve FSH yanıtı olduğu gösterilmiştir (21). Varikoselli erkeklerde GnRH'ya artmış FSH ve LH yanıtı spermatogenezdeki hasara ve Leydig hücresi disfonksiyonuna bağlı olabilir (22). Varikosel onarımının hormonal disfonksiyonu düzelttiği konusunda da bir fikir birliği yoktur.…”

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İnfertil Erkeklerde Yüksek İnguinal ve Mikro Cerrahi İle Subinguinal Varikoselektominin Karşılaştırılması

Talat;GÖKÇE¹

2003

Ankara Üniversitesi Tıp Fakültesi Mecmuası

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Ö ÖZ ZE ET T Bu çalışmada; infertilite tedavisinde yüksek inguinal varikoselektomi, yöntemi ile, subinguinal mikrocerrahiyle varikoselektomi, komplikasyonları, semen parametreleri ve hormon profillerine etkileri açısından karşılaştırılmıştır.Yüksek inguinal yöntemle (Grup 1) 50 olguda 70, subinguinal mikrocerrahiyle (Grup 2) 50 olguda 77 varikoselektomi yapıldı.Grup 1'de olguların sekizinde (%16,6) nüks oluştu ve 5 olguda hidrosel gelişimi (%10,4) saptandı; grup 2'de 2 olguda (%4) nüks saptandı. Grup 2'de hiçbir olguda hidrosel gelişimi gözlenmedi (P<0.05). Grup 1 ve grup 2'de; preoperatif ve postoperatif ortalama sperm sayıları, hareketlilik ve serum hormon düzeyleri arasında anlamlı bir fark bulunamadı. Ancak grup 2'de Serbest Testosteron düze-yindeki artış grup 1'e göre istatiksel olarak anlamlı bulundu (P<0,05).Subinguinal mikroskobik cerrahi lokal anesteziyle uygulanabilmesi, nüks oranının ve hidrosel oluşumunun dü-şük olması nedeniyle varikoselektomide alternatif bir yöntemdir. In this study results of two different varicocelectomy method were compared regarding complications and the effects on semen parameters and hormon profiles in treatment of infertility.Seventy high inguinal ligation of testicular vein in 50 patients (group 1) and 77 subinguinal microsurgical method in 50 patients (group 2) were performed.In group1; eight recurrent varicocele (16,6%), five hydrocele (%10,4) formation were detected in group 1, only two (4%) recurrence were found in group 2 (P<0.05). Hydrocele formation wasn't detected in group 2. Regarding semen parameters and serum FSH, LH and PRL levels, there was no statistically significant difference between preoperative and postoperative results in two groups. But postoperative increase in free testosterone level in group 2 is statistically significantly different from group 1 (P<0.05).Subinguinal microsurgical varicolectomy is an alternative method because of easy applicability, lower reccurence and hydrocele formation rate than the high inguinal method.K Ke ey y W Wo or rd ds s: : Varicocele, Varicocelectomy, Microsurgery, İnfertility.Varikosel; pleksus pampiniformis venlerinin variköz dilatasyonudur. Erkek popülasyonun %10-15'inde bulunur. Bu oran primer infertil erkeklerde %21-41 iken; sekonder infertillerde %70 ila %80'e kadar çıkmaktadır (1,2). Varikosel cerrahisinde amaç; venöz drenajı, testisi varikoselin zararlı etkilerinden koruyacak şekilde düzeltmektir. Bu yapılırken de arteriyel yapılar, vaz deferensler ve lenfatikleri korunmalıdır. . Yüksek inguinal ligasyon uygulanmasının kolay oluşu, pleksus pampi-

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The significance of gonadotropin-releasing hormone test for predicting fertility after varicocelectomy

Cited by 30 publications

References 6 publications

Varicocele Ligation on Free Testosterone Levels in Infertile Men With Varicocele

Varicocele Ligation on Free Testosterone Levels in Infertile Men With Varicocele

Significant improvement of sperm DNA quality after microsurgical repair of varicocele

İnfertil Erkeklerde Yüksek İnguinal ve Mikro Cerrahi İle Subinguinal Varikoselektominin Karşılaştırılması

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