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

Urology. 2015 Jul;86(1):48-51. doi: 10.1016/j.urology.2015.04.014.

Abstract

Objective: To characterize the changes in seminogram findings in infertile men after varicocelectomy.

Methods: This study included 71 consecutive infertile men who underwent microsurgical low ligation varicocelectomy and received 3 semen analyses, 1 before microsurgical varicocelectomy and again at 3 and 12 months after. Total motile sperm count (TMSC) was calculated using the following formula: [volume (mL) × concentration (millions/mL) × motility (%)].

Results: Despite the lack of significant changes in the proportion of sperm with abnormal morphology, sperm concentration, motility, and TMSC in the 71 patients were significantly higher at 3 and 12 months after varicocelectomy than before surgery. However, no further improvement in these parameters at 12 months after varicocelectomy was noted compared with those at 3 months. Furthermore, when the included men were divided into 3 groups according to preoperative TMSC as <3 million, 3-9 million, and >9 million, TMSCs at 3 months after varicocelectomy in all 3 groups were significantly higher than those before varicocelectomy; however, TMSCs at 12 months after surgery in all groups were similar to those at 3 months.

Conclusion: The level of improvement in semen parameters at 3 months after varicocelectomy may be stable at 12 months after surgery, irrespective of baseline values of TMSC. Therefore, varicocelectomy could be offered as a therapeutic option for infertile men, even for couples with an older woman, because its efficacy is evaluable at 3 months after surgery, and assisted reproductive technology could be immediately applied to ineffective cases.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Humans
  • Infertility, Male / diagnosis
  • Infertility, Male / etiology
  • Infertility, Male / metabolism*
  • Ligation
  • Male
  • Microsurgery / methods*
  • Middle Aged
  • Postoperative Complications
  • Prospective Studies
  • Semen Analysis
  • Sperm Motility
  • Time Factors
  • Ultrasonography, Doppler
  • Urologic Surgical Procedures, Male / methods*
  • Varicocele / complications
  • Varicocele / diagnosis
  • Varicocele / surgery*
  • Young Adult