Effect of varicocelectomy on detailed sperm morphology parameters

Abstract

Although many studies suggest that varicocelectomy leads to improvement in semen parameters and morphology, its clinical efficacy remains controversial. The detailed morphological parameters described in the World Health Organization guidelines are important in terms of showing the effect of microsurgical subinguinal varicocelectomy on morphological changes. An observational, retrospective clinical cohort study was conducted with patients followed up from January 2018 to August 2021. This study included the data of 79 patients who met the criterion of undergoing at least 2 detailed morphological evaluations before and after surgery. All operations were performed by the same surgical team using the microsurgical subinguinal varicocelectomy technique. The mean age of the patients was 30.25 years. Of the patients, 63 underwent left-sided varicocelectomy and 16 underwent bilateral surgery. The sperm analysis revealed statistically significant increases in sperm volume ( P = .006), sperm concentration ( P = .003), total sperm count ( P = .001), progressive sperm motility ( P < .001), and normal morphology ( P < .001). In the detailed morphological evaluation, except for the elongated head anomaly ( P = .037), no other statistically significant changes were found in relation to sperm head, tail, and neck anomalies after surgery. This study makes an important contribution to the literature, being the first to use the subinguinal microscopic varicocelectomy technique in detailed morphological semen evaluation. We consider that detailed morphology examination in the selection and treatment of infertile patients may be useful in evaluating the efficacy of varicocelectomy.

Mailuoshutong pill for varicocele-associated male infertility—Phytochemical characterisation and multitarget mechanism

“…Currently, semen quality can be improved and fertility improved in some patients through varicocelectomy (Lira Neto et al, 2021). However, some patients whose semen quality fails to improve after surgery, and the treatment effect is not satisfactory with the use of a single drug (Garg and Kumar, 2016;Yaris and Kilinc, 2022). The main reason for this is that the mechanism of male infertility caused by VC is complex and the use of a single drug, covering too few therapeutic targets, cannot play a better role.…”