Time for Improvement in Semen Parameters After Varicocelectomy

Abstract

Sperm parameters improve by 3 months after varicocele repair and then do not improve further. This finding should allow physicians to decide quickly if varicocelectomy has been effective and, then, if required, plan on the use of other therapies to manage the couples' infertility.

Assessment of Time-dependent Changes in Semen Parameters in Infertile Men After Microsurgical Varicocelectomy

“…The 71 patients in this study were classified into 3 groups according to baseline TMSC values before varicocelectomy; however, time-dependent changes in semen parameters in these 3 groups appeared to be similar to those in the overall cohort of the included patients, which were also supported by the previous study reported by Al Bakri et al 13 These findings suggest that semen parameters may be likely to exhibit uniform timedependent changes after varicocele repair, irrespective of baseline TMSC values before surgery.…”

“…Despite the simultaneous assessment of patients treated with embolization and varicocelectomy based on semen analyses at 3 and 6 months after varicocele repair, Al Bakri et al 13 reported findings similar to those in the present study. Furthermore, Tarhan et al 19 showed the time-dependent changes in testicular blood flow measured by color Doppler sonography, which seem to be proportional to those in the semen parameters presented in our study.…”

“…The American Society for Reproductive Medicine Practice Committee proposed in 2008 that patients wait at least 1 year to evaluate the effect of varicocele repair on the changes in semen parameters and the need to move to other assisted reproductive techniques (ARTs) 11 ; however, this committee modified the report in 2014 as follows: time to improvement is typically 3 to 6 months, which corresponds to 1 to 2 spermatogenic cycles. 12 In fact, Al Bakri et al 13 assessed the proper duration needed for the improvement of sperm parameters after varicocelectomy. The findings indicated that sperm parameters improved by 3 months after surgery and subsequently did not further improve.…”

Clinical Outcomes of Varicocele Repair in Infertile Men: A Review

“…In humans, the entire spermatogenic process takes approximately 64 days [73]. Studies evaluating the time interval between varicocelectomy and improvements in semen parameters revealed that sperm parameters improved during the first 3 months after varicocele repair, but did not show further improvements thereafter [7475]. Correspondingly, the ASRM Practice Committee has stated that improvements in semen parameters are typically seen after 3 to 6 months [12].…”

Subinguinal microsurgical varicocelectomy vs. percutaneous embolization in infertile men: Prospective comparison of reproductive and functional outcomes

“…Nevertheless, contrarily to the generally admitted idea that following varicocele treatment, semen improvement occurs progressively during the first year, we observed for all parameters (concentration, motility, vitality, normal forms and TMSC) a sharp rebound at 3 months, followed by a slight decrease but a level at the last analysis remaining higher than preoperatively. Recently Al Bakri et al reported similarly, that sperm parameters improve by 3 months following varicocele repair and then no more improvement by 6 months or longer [30]. The cause of such phenomenon remains unclear.…”