Varicocele repair in the era of modern assisted reproductive techniques

McIntyre, Matthew; Hsieh, Tung-Chin; Lipshultz, Larry I.

doi:10.1097/mou.0b013e328358e191

Cited by 21 publications

(11 citation statements)

References 25 publications

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“…The effects of the correction of varicocele on sperm quality and reproductive potential are less well understood. Clinical research has demonstrated improved semen parameters, higher DNA integrity, and better assisted reproductive technology outcomes after varicocele repair [24]. …”

Section: Discussionmentioning

confidence: 99%

Beneficial effects of varicocele embolization on semen parameters

Prasivoravong

Marcelli²,

Lemaître

et al. 2014

Basic Clin. Androl.

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BackgroundThe value of varicocele repair and the latter's impact on semen parameters are still subject to debate.MethodsWe analyse changes over time in initially abnormal sperm parameters and serum concentrations of testosterone, FSH and inhibin B after embolization treatment of males with high-grade varicocele. From 2007 to 2012, we recruited 47 male infertile patients with clinically visible left varicocele in the resting patient and at least one abnormal semen parameter. Sperm parameters and serum levels of total testosterone, FSH and inhibin B were measured prior to retrograde embolization (M0) and then 3 (M3) and 6 (M6) months afterwards.ResultsAt M0, the median sperm concentration was 5.78 [0.84-37.70] × 106/ejaculate. The mean ± SD sperm progressive motility, vitality and percentage of normal sperm were respectively, 21.83 ± 16.48%, 61.88 ± 15.98% and 12.88 ± 7.15%. The corresponding values at M3 were significantly higher (38.75 [3.96-95] × 106/ejaculate, 29.32 ± 14.21%, 69.14 ± 14.86% and 19.03 ± 11.02%, respectively). The mean percentage of spermatozoa with a thin head was significantly lower at M6 (6.35 ± 5.29%) than at M0 (14.03 ± 13.09%). The mean serum testosterone, FSH and inhibin B levels did not change significantly over time.ConclusionsEmbolization treatment in men with clinically visible left varicocele, abnormal sperm parameters and documented infertility is associated with a significant improvement in semen parameters including sperm head morphology.

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Section: Discussionmentioning

confidence: 99%

Beneficial effects of varicocele embolization on semen parameters

Prasivoravong

Marcelli²,

Lemaître

et al. 2014

Basic Clin. Androl.

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“… 6 7 14 15 However, it is unclear whether performing varicocelectomy in infertile males with clinical varicocele prior to ART improves treatment outcomes. 16 …”

Section: Introductionmentioning

confidence: 99%

Outcome of assisted reproductive technology in men with treated and untreated varicocele: systematic review and meta-analysis

Esteves¹,

Roque²,

Agarwal

2016

Asian J Androl

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Varicocele affects approximately 35%–40% of men presenting for an infertility evaluation. There is fair evidence indicating that surgical repair of clinical varicocele improves semen parameters, decreases seminal oxidative stress and sperm DNA fragmentation, and increases the chances of natural conception. However, it is unclear whether performing varicocelectomy in men with clinical varicocele prior to assisted reproductive technology (ART) improve treatment outcomes. The objective of this study was to evaluate the role of varicocelectomy on ART pregnancy outcomes in nonazoospermic infertile men with clinical varicocele. An electronic search was performed to collect all evidence that fitted our eligibility criteria using the MEDLINE and EMBASE databases until April 2015. Four retrospective studies were included, all of which involved intracytoplasmic sperm injection (ICSI), and accounted for 870 cycles (438 subjected to ICSI with prior varicocelectomy, and 432 without prior varicocelectomy). There was a significant increase in the clinical pregnancy rates (OR = 1.59, 95% CI: 1.19–2.12, I2 = 25%) and live birth rates (OR = 2.17, 95% CI: 1.55–3.06, I2 = 0%) in the varicocelectomy group compared to the group subjected to ICSI without previous varicocelectomy. Our results indicate that performing varicocelectomy in patients with clinical varicocele prior to ICSI is associated with improved pregnancy outcomes.

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“…Recent papers have justified the increase of testicular volume for intratesticular interstitial edema, but other follow-up reveal this is because of a real growth of testis that improves with time (25,26). Many cases in the literature showed improvement in sperm quality after varicocelectomy; however, the data are few because spermiogram analysis cannot be obtained at pediatric age (27). Mancini et al in 2014 have also to analyzed the volume of testis and the quality of semen in patients treated with both minimally invasive approaches (transperitoneal approach and retroperitoneoscopy approach) (21).…”

Section: Resultsmentioning

confidence: 99%