Infertility duration and pre‐operative sperm progressive motility are significant factors of spontaneous pregnancy after varicocele repair

Abstract

Problem: Varicocele may lead to testicular dysfunction and male infertility. Varicocelectomy can improve both semen quality and post-operative spontaneous pregnancy. However, different patients benefit distinctly from the surgery. Therefore, the study aims at examining the possible factors of spontaneous pregnancy after laparoscopic varicocelectomy in infertile men. Method of study: Clinical data of 196 infertile men who underwent laparoscopic varicocelectomy at our institute were collected from December 2013 to February 2019. Follow-up data were available for 148 patients. All the patients were treated with laparoscopic varicocelectomy performed by experienced urological doctors. Possible pre-operative factors of spontaneous pregnancy after laparoscopic varicocelectomy were retrospectively analyzed. Results: After a mean follow-up of 29.1 ± 12.6 months (range 12-74 months), 74 (50%) of couples achieved spontaneous pregnancy. Univariate analysis revealed that short infertility duration, secondary infertility, and high sperm progressive motility were significant predictors of spontaneous pregnancy after laparoscopic varicocelectomy. Multivariate analysis revealed that short infertility duration (≤2 years) and high sperm progressive motility (>30%) were independent predictors. Conclusion: Both infertility duration and pre-operative sperm progressive motility could serve as independent factors of spontaneous pregnancy after laparoscopic varicocelectomy.

The Negative Impact of Varicocele on Basic Semen Parameters, Sperm Nuclear DNA Dispersion and Oxidation-Reduction Potential in Semen

“…It should be highlighted that some factors can be eliminated, while diagnostic parameters can be modified using proper medical management based on examination and in-depth medical interviews. Recent studies have shown that modification of unhealthy habits (e.g., smoking, alcohol abuse, drugs, and being overweight), administration of antioxidant therapy, and varicocelectomy in cases of varicocele-mediated infertility can contribute to restoring physiological levels of ROS and to improving semen quality, including the integrity of sperm DNA [ 8 , 9 , 10 , 12 , 13 , 14 , 15 , 16 , 21 , 29 , 48 ]. Moreover, in the era of growing numbers of chronic disease cases (e.g., insulin resistance, cancers, cardiovascular disease, and being overweight), it cannot be ignored that the adoption of healthy habits can additionally improve general male health and may contribute to a lower cost of medical care in the future.…”

“…In the general population, approximately 15% of adult men have varicoceles, but in the population of infertile men, the prevalence rises to 40% (primary infertility) or even to 80% (secondary infertility) [ 4 , 5 , 6 , 7 , 8 ]. Therefore, proper medical examination of the scrotum is essential for the management of male infertility [ 4 , 5 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 ].…”

Sterility, an Overlooked Health Condition

“…An older meta-analysis paper that included seven studies totaling 281 couples between 1979 and 2001 estimated that 78% of infertile couples treated with varicocele repair were unable to produce a live birth [87]. Seven other papers analyzed 594 couples between the years 1998 and 2019 [88][89][90][91][92][93][94] (Table 2). In all studies, most infertile couples failed to deliver a biological child (78%, 67%, 81%, 50%, 90%, 79%, and 75%) with a weighted average of 69%.…”