Are varicoceles associated with increased deoxyribonucleic acid fragmentation?

Zini, Armand; Dohle, Gert R.

doi:10.1016/j.fertnstert.2011.10.016

Cited by 153 publications

(114 citation statements)

References 79 publications

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“…17,18 No morbidity and mortality were encountered in the study, with little likelihood of recurrence of the condition. The semen profile was improved, including a decreased sperm DNA fragmentation rate as observed in a review of varicoceles and DNA fragmentation 19 and successful pregnancy favor this approach as an established, safe, and effective treatment of male infertility.…”

Section: Discussionmentioning

confidence: 91%

Laparoscopic Varicocelectomy: My Personal Experience of 4000 Cases

Chen

2016

International Surgery

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Varicocele accounts for 40% of male infertility. Laparoscopic varicocelectomy was used for the treatment of a series of 4000 men. The operation was a high bilateral ligation. The average time for the operation was 1 hour and 15 minutes. There were no complications and patients were discharged on the same day of the operation. Testicular damage from varicocele was permanent, and the usual percentage was 10% of total testicular tissue examined. The surgery was very well accepted by patients. Semen parameters improved among 80% of the patients, with 45% of their wives becoming pregnant. There is clearly a role for video laparoscopic varicocelectomy in the treatment of male infertility.Key words: Varicocele -Laparoscopic varicocelectomy -Male infertility -Abnormal semen I t is common knowledge that fertility is declining worldwide, with a rate of 25% among couples 1,2 ; of that number, the male contribution is conservatively at approximately 45%.3 While there are multiple causes in the male, one major cause is varicocele, which now cannot be ignored or even brushed off as controversial. In fact, both the American Society for Reproductive Medicine and the American Urological Association have found that varicocele causes infertility. 4 The incidence of varicocele can vary between 19% and 41% (the incidence is more reflective to that of 41%). 5,6 Varicocele has been shown not to begin at adulthood, but more likely at adolescence or 9 As a result of leakage, there is a backflow of renal blood down these veins. This renal reflux results in toxic damage to both spermatogenesis and male hormone production by the Leydig cell. 10Consequently, the testes are damaged in varying progressive stages over time. There is hyperthermia, testicular shrinkage and atrophy, sperm membrane damage, chromosomal breaks, spermatogenic arrest, maturation arrest, Sertoli cell destruction, and germinal epithelial sloughing. Male hormone production also declines, which affects health, and accelerates andropause. In its earlier subclinical stages, varicocele is diagnosed by Doppler ultrasound, whereas in its later more advanced clinical stages, the swollen veins become palpable. The condition is bilateral, but may appear to manifest unilaterally.When medically indicated for clinically significant varicoceles, many treatment options have been used over time.11 On the whole, the treatment for the varicocele is surgical by occlusion of the testicular veins. The previous common approach is the inguinal route, but there is a 40% recurrence rate. 12Scrotal varicocelectomy is not practiced because of its poor smaller vessels and poor results. Thus, a high peritoneal varicocelectomy approach through the abdomen is more effective because there are fewer and larger varicose veins. 13,14 Methods PatientsThis study involved 4000 laparoscopic varicocelectomies for infertility from 1995 15 to 2015. Their ages ranged from 26 and 68 years. The majority were in the age group of 30 to 34 years, with a 3-year history of infertility. These men had semen analysis. Ind...

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Section: Discussionmentioning

confidence: 91%

Laparoscopic Varicocelectomy: My Personal Experience of 4000 Cases

Chen

2016

International Surgery

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“…Our data suggested that down-regulation of SOD1 in patients with varicocele and abnormal spermogram can elevate DNA fragmentation and apoptosis, but after varicocelectomy, SOD1 activity increases and it can be resulted in improving DNA damage. Several studies have demonstrated that the total seminal plasma antioxidant levels in patients with varicocele are decreased and DNA damage in these patients was increased [12][13][14][15][16][17][18]. Moreover, some studies have shown that varicocelectomy can improve DNA fragmentation and total antioxidant capacity [19,20].…”

Section: Discussionmentioning

confidence: 99%

Study of the effect of varicocelectomy on sperm proteins expression in patients with varicocele and poor sperm quality by using two-dimensional gel electrophoresis

Hosseinifar

Sabbaghian

Nasrabadi

et al. 2014

J Assist Reprod Genet

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Purpose To compare proteomic profiles of spermatozoa from patients with varicocele and poor sperm quality before and after varicocelectomy. Methods This work was designed as a prospective and observational study. The study was based on 20 men with varicocele grade 3 and poor sperm quality undergoing varicocelectomy at the Fertility Unit of Royan institute in 2009. Two semen samples were collected, one before varicocelectomy and the other after surgery. Protein separation was done by two-dimensional protein electrophoresis, and analyzed by gel densitometry and mass spectrometry. Differential sperm protein expression levels were measured by gel densitometry. Results Comparison of the sperm parameters showed that sperm motility and concentration were increased after varicocelectomy. At the level of protein, a total of 3 protein spots were identified whose expression was significantly lower in sperm samples before varicocelectomy compared with after surgery including heat shock protein A5 (HSPA5), superoxide dismutase 1 (SOD1) and δ-subunit of the catalytic core of mitochondrial adenosine triphosphate synthase (ATP5D). Conclusions High grade varicocoele affects sperm protein expression presumably because of increasing testicular temperature. These proteins play essential roles in sperm production, DNA integrity protection, and sperm motility. This novel study demonstrates that varicocelectomy can improve both sperm quality and proteins expression.

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“…Varicocele is associated with increased sperm DNA damage, and this sperm pathology may be secondary to varicocele-mediated oxidative stress. Varicocelectomy can reverse this sperm DNA damage, as shown in several studies [ 10 ].…”

Section: Heatmentioning

confidence: 74%

Varicocele and Infertility

Beretta¹

2014

Clinical Management of Male Infertility

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Va ricoceles are abnormally dilated testicular veins (pampiniform plexus) in the scrotum, normally secondary to internal spermatic vein refl ux. This common abnormality has implications such as pain and testicle discomfort, failure of testicular growth, and infertility.Ambroise Pare defi ned this anatomic problem in 1550 as a tumor of dilated veins, "a compact pack of vessels fi lled with melancholic blood" [ 1 ]. A modern defi nition of varicocele is a pathologic dilation of the pampiniform plexus or of the cremasteric venous system that is suffi cient to allow a retrograde fl ow of blood back into the venous system when the intra-abdominal pressure increases. Varicocele is a physical abnormality present in 11.7 % of men with normal semen analysis, 25.4 % of men with abnormal semen [ 2 ], approximately 25 % of the normal male population, and up to 40 % of men presenting with infertility; it occurs on the left side in as many as 98 % of patients [ 3 ].The following classifi cation of varicocele is useful in clinical practice:(a) Subclinical varicocele: Not palpable or visible at rest or during Valsalva maneuver but is demonstrable by scrotal ultrasonography and color Doppler examination (b) Grade 1: Palpable during Valsalva maneuver but not otherwise (c) Grade 2: Palpable at rest but not visible (d) Grade 3: Visible and palpable at rest [ 4 , 5 ].

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Are varicoceles associated with increased deoxyribonucleic acid fragmentation?

Cited by 153 publications

References 79 publications

Laparoscopic Varicocelectomy: My Personal Experience of 4000 Cases

Laparoscopic Varicocelectomy: My Personal Experience of 4000 Cases

Study of the effect of varicocelectomy on sperm proteins expression in patients with varicocele and poor sperm quality by using two-dimensional gel electrophoresis

Varicocele and Infertility

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