Percentage change of FSH value: new variable to predict the seminal outcome after varicocelectomy

Abstract

In the literature, there is no good agreement with variables to predict seminal outcome after varicocelectomy. The purpose of this study was to evaluate the FSH percentage change (Δ% FSH) as a predictor of the seminal outcome after varicocelectomy together with other known predictors. We evaluated 118 patients who underwent varicocelectomy. We assessed factors that could be predictors of the improvement of semen characteristics: LH, FSH, total and free testosterone before operation, testis volume, age, testicular pain, body mass index (BMI), Δ% FSH, varicocele Doppler ultrasound grade using regression analysis. Mean sperm concentration increased from 27 ± 12 to 52 ± 15 million per ml post-operatively (P < 0.003), mean sperm motility increased from 31 ± 12 to 40 ± 13 million per ml following the operation (P < 0.02), also mean FSH value changed from 10.2 ± 8.3 to 6.7 ± 7.2 UI/L (P < 0.01). In unvaried regression analysis, Δ% FSH, BMI and age were predictors of the improvement of semen characteristics. In multiple regression analysis, only Δ% FSH and age were predictors. Negative correlation with age and positive correlation with Δ% FSH were observed. Our findings suggest that Δ% FSH (before and after varicocelectomy) and age are significant factors predicting the improvement of semen characteristics.

Correlation between Serum Kisspeptin and Spermatogenic Function in Men

“…The hypothalamus' pulsatile secretion of gonadotropinreleasing hormone (GnRH) acts on the pituitary gland to promote synthesis and secretion of FSH. FSH then acts on the seminiferous tubules and Sertoli cells to promote the development of spermatocytes of all stages and sperm maturation [13,14].…”

The clinical usefulness of a novel grading system for varicocoeles using duplex Doppler ultrasound examination based on postsurgical modifications of seminal parameters

“…Right testicular volume and FSH were associated with postoperative semen modifications. Even though a moderate decrease in FSH level occurs after surgery (Cantoro et al ., ), it is well known that basal FSH is inversely related to sperm count while right testicular volume is directly related to sperm count (Zucchi et al ., ; Chen, ), and the data in this study confirmed this fact.…”

Effects of varicocelectomy on serum testosterone

“…Ten of thirteen studies without improved TT had starting average TT >450 ng/dL (7,24,25,30,33,35,36,44-46). Therefore, given the already normal TT, it remains unlikely that an appreciable increase in serum TT would be observed.…”

“…There was no significant change in serum TT after 3 and 6 months. Cantoro et al (46) recently also demonstrated no improvement in TT in a retrospective study of 218 men with infertility or symptomatic varicocele undergoing retrograde internal spermatic vein scleroembolization after 6 months.…”

“…Despite initial promise that varicocele embolization results in improved TT (26,27), no studies apart from the initial single institution have reproduced this data (33,44-46). Currently it is difficult to recommend varicocele embolization to treat hypogonadism in men with varicocele.…”