The Effect of Prior Varicocelectomy in Patients With Nonobstructive Azoospermia on Intracytoplasmic Sperm Injection Outcomes: A Retrospective Pilot Study

Haydardedeoğlu, Bülent; Turunç, Tahsin; Kılıçdağ, Esra Bulgan; Gül, Ümit; Bağış, Tayfun

doi:10.1016/j.urology.2009.09.023

Cited by 85 publications

(83 citation statements)

References 13 publications

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“…In addition, although their study included men with NOA and subclinical varicoceles, a history of prior varicocele repair did not increase the likelihood of sperm retrieval when testicular sperm retrieval (testicular sperm extraction, TESE) was performed. In contrast, subsequent studies have shown varicocele treatment to be effective in men with NOA [8283]. Recently, Esteves et al [84] conducted a systematic review evaluating the outcomes of varicocele repair in men with NOA.…”

Section: Varicoceles In Men With Azoospermiamentioning

confidence: 99%

Clinical Outcomes of Varicocele Repair in Infertile Men: A Review

Chiba

Fujisawa

2016

World J Mens Health

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Varicoceles are a major cause of impaired spermatogenesis and the most common correctable cause of male infertility. They are found in approximately 40% of men with primary infertility and 80% of men with secondary infertility, although they also occur in 12% of men with normal semen parameters. The presence of a varicocele does not always affect spermatogenesis, as it has been reported that only 20% of men with documented varicoceles suffer fertility problems. However, varicocele repair appears to have beneficial effects in men with impaired semen parameters and palpable varicoceles. Currently, the main procedures employed for varicocele repair are microsurgical subinguinal or inguinal varicocelectomy, laparoscopic varicocelectomy, and radiological percutaneous embolization. Microsurgical varicocelectomy appears to be the optimal treatment in most cases, whereas the other procedures are useful only in specific cases. After treatment, it typically takes 3 to 6 months for patients' semen parameters to improve; thus, other therapies, including assisted reproductive technology, should be considered if infertility persists after this interval, especially in older couples. Controversies still remain regarding how varicoceles in certain subgroups, such as adolescents or men with azoospermia, should be treated. Due to their relatively high prevalence rate among the general population, varicoceles can occur concomitantly with other conditions that cause impaired spermatogenesis. Further studies are necessary in order to identify the patients who are most likely to benefit from treatment. In this review, we sought to summarize the issues currently associated with varicocele treatment in infertile men.

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Section: Varicoceles In Men With Azoospermiamentioning

confidence: 99%

Clinical Outcomes of Varicocele Repair in Infertile Men: A Review

Chiba

Fujisawa

2016

World J Mens Health

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“…That study also indicated the SRR was not influenced by whether the patient underwent varicocelectomy or not [50]. At the same time, improvement of the SRR [51] or improvement of the clinical pregnancy rate and live birth rate [52] have also been reported among NOA patients with varicocele. Furthermore, a meta-analysis of 233 NOA patients with varicocele showed a spontaneous pregnancy rate of 6 % following treatment of varicocele [53].…”

Section: Noa With Varicocelementioning

confidence: 67%

Management of non‐obstructive azoospermia

Chiba

Enatsu

Fujisawa

2016

Reprod Medicine & Biology

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Non-obstructive azoospermia (NOA) is defined as no sperm in the ejaculate due to failure of spermatogenesis and is the most severe form of male infertility. The etiology of NOA is either intrinsic testicular impairment or inadequate gonadotropin production. Chromosomal or genetic abnormalities should be evaluated because there is a relatively high incidence compared with the normal population. Although rare, NOA due to inadequate gonadotropin production is a condition in which fertility can be improved by medical treatment. In contrast, there is no treatment that can restore spermatogenesis in the majority of NOA patients. Consequently, testicular extraction of sperm under an operating microscope (micro-TESE) has been the firstline treatment for these patients. Other treatment options include varicocelectomy for NOA patients with a palpable varicocele and orchidopexy if undescended testes are diagnosed after adulthood, although management of these patients remains controversial. Advances in retrieving spermatozoa more efficiently by micro-TESE have been made during the past decade. In addition, recent advances in biotechnology have raised the possibility of using germ cells produced from stem cells in the future. This review presents current knowledge about the etiology, diagnosis, and treatment of NOA.

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“…Vascular perfusion appears to affect the quality of spermatogenesis [30]. Indeed, several reports have shown associated derangements in semen parameters when varicocele is present [11,12], and shown improvements when varicocele is corrected [8,10,14,15,22,31,32]. However, this association is not consistent.…”

Section: Repaired Not Repairedmentioning

confidence: 99%

“…One possible optimization intervention is varicocele repair [8]. Varicocele is a relatively common pathology [9], found in around 5%-10% of azoospermia cases [10]. Its negative effects on fertility has been recognized [11]; a study of over 9000 men presenting to infertility clinics indicated a significant association between varicoceles and abnormal semen findings, testicular-volume parameters, as well as other parameters of testicular function [12].…”

Section: Introductionmentioning

confidence: 99%