Does varicocelectomy improve semen in men with azoospermia and clinically palpable varicocele?

Elbardisi, Haitham; Ansari, Walid El; Majzoub, Ahmad; Arafa, Mohamed

doi:10.1111/and.13486

Cited by 14 publications

(13 citation statements)

References 56 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…All studies included participants that had a diagnosis of NOA and clinically significant varicoceles, although some studies confirmed varicocele presence with ultrasonography. The average sample size was 43 and mean (range) duration of follow-up was 10.5 (6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22) months (Table 1 [8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23]).…”

Section: Resultsmentioning

confidence: 99%

“…A total of 13 of the studies assessed spermatogenesis after VR with an average rate of 27.3% [8][9][10][11][12][13][14][15][16][17][18][19][20]. For two of those studies, the sperm were specified to be motile [9,11].…”

Section: Presence Of Sperm In Postoperative Ejaculatementioning

confidence: 99%

“…Testicular histopathology was reviewed in eight of the included papers [8,[11][12][13][14][15]18,20,23…”

Section: Histopathologymentioning

confidence: 99%

See 2 more Smart Citations

Varicocele treatment in non-obstructive azoospermia: a systematic review

Jensen

2021

Arab Journal of Urology

View full text Add to dashboard Cite

Objective: To review the available literature and identify factors associated with successful outcomes after varicocele repair (VR) in the setting of non-obstructive azoospermia (NOA). Methods: The PubMed and EMBASE databases were searched for relevant articles. Primary outcomes were return of spontaneous spermatogenesis, sperm retrieval rates (SRRs), and unassisted and assisted pregnancy rates. Histopathological subtypes, when available, were used for subgroup analysis. Results: A total of 16 articles were finally included. The average sample size was 43 and average duration of follow-up was 10.5 months. The average rate of primary spermatogenesis after VR was 27.3%. The average SRR, across five studies in men with NOA undergoing microscopic testicular sperm extraction status after varicocelectomy, was 48.9% vs 32.1% for the untreated cohort groups, and the average spontaneous pregnancy rate was 5.24%. Histopathology subtype was a significant contributing factor when analysed. Conclusion:Varicocele repair should be considered in men with NOA, as it may allow some patients to avoid assisted reproductive technologies and improves success rates when utilised.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Presence Of Sperm In Postoperative Ejaculatementioning

confidence: 99%

See 1 more Smart Citation

Varicocele treatment in non-obstructive azoospermia: a systematic review

Jensen

2021

Arab Journal of Urology

View full text Add to dashboard Cite

show abstract

“…Varicocele can negatively impact appropriate sperm production leading to decreased fertility and complete azoospermia in 4%‐14% of patients (Elbardisi et al., 2020). As spermatogenesis is under gonadotropic and androgenic control, the effects of hormonal changes in this system on treatment success in patients with varicocele‐related infertility have been a subject of curiosity.…”

Section: Discussionmentioning

confidence: 99%

Can preoperative gonadotropin and testosterone levels predict the success of varicocelectomy?

Erdoğan

Durmuş

2020

Andrologia

View full text Add to dashboard Cite

We examined the effects of preoperative hormonal values on varicocelectomy success. A total of 136 patients who underwent varicocelectomy for infertility in our clinic were analysed retrospectively. Improvement in semen quality was defined as >50% increase in post‐operative total motile sperm count (TMSC) in those with preoperative TMSC >5 million and at least 100% increase in those with <5 million. The patients were divided into two groups as benefiting from the treatment (Group A) and no benefits (Group B). The best cut‐off value for follicle‐stimulating hormone (FSH) and the luteinising hormone/testosterone ratio (LTR) that can predict varicocelectomy success were 7.01 and 0.016 with an area under the curve of 0.844 and 0.856 respectively. The highest sensitivities and specificities of FSH and LTR were 0.845 and 0.788 and 0.821 and 0.846 respectively. Binary logistic regression analysis showed FSH (odds ratio [OR]: 3.7; p < .001) and LTR (OR: 5.2; p < .001) as independent predictive factors in predicting varicocelectomy success. Our study demonstrated that low FSH (7.01 IU/L) and LTR (<.016) can be a useful preoperative predictive tool to help identify men who benefit most from varicocelectomy in infertile patients with varicocele.

show abstract

“…1 Varicocele can negatively impact appropriate sperm production leading to decreased fertility and complete azoospermia in 4%−14% of patients. 2 The proposed detrimental effects of varicocele on testicular function include oxidative stress, high scrotal temperature with loss of the scrotal counter-cooling mechanism, reflux of adrenal metabolites, and changes in androgen production. 3 , 4 …”

Section: Introductionmentioning

confidence: 99%

Effect of microsurgical varicocelectomy on semen parameters, serum, and intratesticular testosterone levels

et al. 2020

View full text Add to dashboard Cite

Objective The goal of this work was to evaluate if men who underwent microsurgical varicocelectomy would have improvement in serum testosterone (T) as well as serum 17-hydroxyprogesterone (17-OHP—An intratesticular T biomarker) in addition to semen parameters after operation. Materials and Methods We conducted a prospective analysis of 30 men who underwent microsurgical varicocelectomy from December 2018 to September 2019. We assessed varicocele grade and laterality, serum T, serum 17-OHP, serum follicle- stimulating hormone (FSH), serum LH, and semen parameters in baseline and follow-up. According to the data distribution, we reported the median and interquartile ranges and utilized the Mann-Whitney U, Student’s t test and Wilcoxon rank test. Correlation analysis was performed with the Spearman test. Results In the baseline, 9 (30%) men had 17-OHP < 55 ng/dL and 21 (70%) men presented with 17-OHP > 55 ng/dL. Also, 19 men had TMSC < 9 million, including 6 men with azoospermia, 1 man with cryptozoospermia, and 11 men with TMSC > 9 million. We found an improvement in most SA parameters of most men, which include concentration (63.3%, 19/30), motility (46.6%, 14/30), and TMSC (60%, 18/30). About seven (36.8%) men had TMSC upgraded to > 9. There was a significant change in volume (2.1 [1.5–2.8] to 2.4 [1.7–3.6] cc, P = .018), concentration (6.8 [0.8–22.5] to 12.5 [1–31] million/cc, P = .047) and TMSC (4.4 [0.3–15.1] to 10.5 [0–41.8] million, P = .012) after surgery. We neither found a change in serum T nor a change in intratesticular T (serum 17-OHP) after varicocelectomy ( P > .05). FSH, LH and T were similar both before and after varicocelectomy ( P > .05). Conclusion Despite improvement in semen parameters following varicocelectomy, we did not see changes in either serum or intratesticular T. This suggests that improvement of semen parameters following varicocele repair could be from factors other than changes in androgen levels within the testis.

show abstract

Does varicocelectomy improve semen in men with azoospermia and clinically palpable varicocele?

Cited by 14 publications

References 56 publications

Varicocele treatment in non-obstructive azoospermia: a systematic review

Varicocele treatment in non-obstructive azoospermia: a systematic review

Can preoperative gonadotropin and testosterone levels predict the success of varicocelectomy?

Effect of microsurgical varicocelectomy on semen parameters, serum, and intratesticular testosterone levels

Contact Info

Product

Resources

About