The predictive value of the platelet volume parameters in evaluation of varicocelectomy outcome in infertile patients

Abstract

The aim of this study was to evaluate the role of platelet count (PLT) and platelet volume indices (PVI) such as mean platelet volume (MPV), platelet distribution width (PDW) and plateletcrit (PCT) as a clinical biomarker in 64 infertile males with varicocele and 45 controls. In addition, semen parameters, serum total testosterone, FSH and testicular volume were measured before and at 6 months after varicocelectomy. The mean PLT, MPV, PDW and PCT were 231 ± 42 × 103/µl, 9.6 ± 1.8 fl, 16.2 ± 2.5 fl and 0.18% in the patient group respectively. When the patient and control groups were compared, there was a significant increase in mean MPV, PDW and PCT (p < .0001), while platelet count was lower in patients than control group, but with no significant relationship. MPV had a significant negative correlation with total testosterone (p < .03). No significant correlations were found between PVI and testicular volume. After follow-up of 37.1 ± 1.9 months, a significant negative correlation was found between the preoperative MPV and varicocelectomy outcome in terms of semen values (p < .007). So, the increase in MPV and low total testosterone in men with varicocele may be a feature of high risk of infertility. K E Y W O R D Sinfertility, mean platelet volume, platelets count, semen parameters, varicocele 2 of 5 | GHANEM Et Al. | MATERIAL S AND ME THODS | Study sampleA total of 180 clinically diagnosed varicocele cases referred to our urology department with infertility. From this group, 64 patients with abnormal semen values underwent varicocelectomy. Forty-five infertile varicocele cases with normal semen values were randomly selected, included as control group, with a similar age between two groups. The protocol of this study followed the guidelines of the Declaration of Helsinki. Also, all the participants provided us a consent. | Selection criteriaPatient was initially included with the complaints of infertility and abnormal semen values by using WHO criteria (2010). Patients were included after excluding other genital diseases, exposure to gonadotoxins, sperm antibodies, endocrinological and internal diseases. In addition, patients with vascular problems (e.g., peripheral vascular disease, heart disease, thrombocytopenic purpura, thrombocytopenia, leukaemia and splenectomy) were excluded.The varicocele diagnosis was assigned by using the 1993 WHO guidelines. Patients with grade 1 varicocele were excluded from the study. The testicular volume was calculated by colour Doppler ultrasonography using Schiff formula (Schiff, Li, & Goldstein, 2004). | Laboratory analysisPeripheral venous samples were drawn into blood tubes containing ethylenediaminetetraacetic acid, early morning following an overnight fast, before varicocelectomy. All samples were analysed within 2 hr (Lance, Oerle, Henskens, & Marcus, 2010). The PLT and PVI (MPV, PDW and PCT) were measured using an automated blood cell analyser. Also, serum FSH, total testosterone levels and semen analysis were evaluated by using the procedure described by Mitchell et al. ...

What is the role of pre‐operative blood parameters in forecasting varicocelectomy success?

“…Other studies have found a significant relationship between a high MPV value and decreased sperm motility in patients with varicocoele, 27,28 and one study suggests that the MPV value correlates positively with the degree of varicocoele 11 . Another study determined that the MPV value of patients with varicocoele was higher than that of the control group, but the decrease in the MPV value after the operation was not found to be statistically significant 29 . We found that the MPV value was statistically higher in the group benefiting from microscopic varicocelectomy than in the other group.…”

Platelet volume parameters as a tool in the evaluation of acute ischemic priapism in patients with sickle cell anemia

“…The potential pathogenic and diagnostic roles of platelets in vascular pathologies have been described in many papers. The PLT and related platelet volume indices (PVIs) have been identified as markers of thrombocyte reactivity in various vascular and urological diseases (17)(18)(19)(20). Priapism is a vascular disease with a veno-occlusive mechanism and endothelial damage as its main pathophysiological basis (20).…”

“…Peripheral blood samples were collected in tubes containing EDTA-K2 (potassium ethylenediaminetetraacetic acid) anticoagulant before any form of priapism intervention from patients and control subjects. Samples were analyzed within one hour of the patient's referral (16)(17)(18). An automated blood cell counter (Sysmex Corp., Japan) was used to measure PLT, PVIs (MPV, PDW, and PCT), and total leukocyte count (TLC).…”

Platelet indices and varicocele: A systematic review and meta‐analysis

“…Further reading the full text of the remaining 16 articles, a meta-analysis and six editorials letters were excluded again. Finally, we enrolled nine studies in our systematic review and meta-analysis, which met all of our pre-set inclusion criteria (Bozkurt et al, 2012;Camoglio et al, 2015;Coban et al, 2015aCoban et al, , 2015bDemirer et al, 2018;Ghanem et al, 2020;Mahdavi-Zafarghandi et al, 2014;Polat et al, 2017;Zhang et al, 2019). After screening the cited references of the remaining nine studies, no further articles were identified for meet the inclusion criteria.…”