Correlation of 17-OH Progesterone Changes With Semen Parameters and Pregnancy Outcomes in Hypogonadal and Eugonadal Patients After Varicocelectomy

Muhammed Arif Ibis; Selman Unal; Ezel Aydog; Efe Semetey Oguz; Murat Can Karaburun; Cagri Akpinar; Kaan Aydos; Onder Yaman

doi:10.1016/j.urology.2025.03.007

Correlation of 17-OH Progesterone Changes With Semen Parameters and Pregnancy Outcomes in Hypogonadal and Eugonadal Patients After Varicocelectomy

Urology. 2025 Mar 12:S0090-4295(25)00236-5. doi: 10.1016/j.urology.2025.03.007. Online ahead of print.

Authors

Muhammed Arif Ibis¹, Selman Unal², Ezel Aydog³, Efe Semetey Oguz⁴, Murat Can Karaburun⁵, Cagri Akpinar⁶, Kaan Aydos⁷, Onder Yaman⁸

Affiliations

¹ Center for Research on Human Reproduction, Ankara University School of Medicine, Ankara, Turkey; Department of Urology, Ankara University School of Medicine, Ankara, Turkey. Electronic address: m.arifibis@hotmail.com.
² Department of Urology, Bilkent City Hospital, Ankara, Turkey. Electronic address: drselmanunal@gmail.com.
³ Department of Urology, Ankara University School of Medicine, Ankara, Turkey. Electronic address: ezelaydog@gmail.com.
⁴ Department of Urology, Ankara University School of Medicine, Ankara, Turkey. Electronic address: semeteyoguz@gmail.com.
⁵ Department of Urology, Ankara University School of Medicine, Ankara, Turkey. Electronic address: muratkaraburun2@gmail.com.
⁶ Department of Urology, Ankara University School of Medicine, Ankara, Turkey. Electronic address: akpinar.cagri89@gmail.com.
⁷ Center for Research on Human Reproduction, Ankara University School of Medicine, Ankara, Turkey; Department of Urology, Ankara University School of Medicine, Ankara, Turkey. Electronic address: drkaanaydos@gmail.com.
⁸ Department of Urology, Ankara University School of Medicine, Ankara, Turkey. Electronic address: monder.yaman@gmail.com.

PMID: 40086513
DOI: 10.1016/j.urology.2025.03.007

Abstract

Objective: To evaluate the impact of varicocele repair on serum 17-OH progesterone (17-OHP) levels and investigate its relationship with semen parameters and pregnancy outcomes in hypogonadal and eugonadal patients. Additionally, to address the unclear association between varicocele and serum 17-OHP levels in male infertility.

Methods: This prospective study included 135 men who underwent microscopic subinguinal varicocelectomy. Pre-operative and post-operative (3-6 months) hormone levels, including follicle-stimulating hormone, luteinizing hormone, total testosterone (TT), and 17-OHP, and semen parameters, such as total motile sperm count (TMS) and sperm morphology, were analyzed. Patients were categorized as hypogonadal (TT <300 ng/dL) or eugonadal (TT ≥300 ng/dL). Pregnancy outcomes were recorded over a 12-month follow-up period.

Results: Significant increases in TT and 17-OHP levels were observed only in hypogonadal men, while TMS and sperm morphology improved in both groups. In hypogonadal men, changes in serum 17-OHP levels (Δ-17-OHP) positively correlated with TMS improvement (r = 0.388, P = .009). Furthermore, in hypogonadal patients, although not statistically significant, Δ-17-OHP were higher in men whose partners achieved pregnancy compared to those whose partners did not.

Conclusion: Varicocele repair improves semen parameters in both hypogonadal and eugonadal men. In hypogonadal men, increases in Δ-17-OHP are linked to TMS improvements, highlighting its potential as a clinical biomarker. Further studies are warranted to validate 17-OHP as a predictor of pregnancy outcomes.