Varicocelectomy in men with nonobstructive azoospermia: Is it beneficial?

Youssef, Tamer; Abd-Elaal, Ebraheim; GabAllah, Ghada M K; Elhanbly, Samir; Eldosoky, Ebraheim

doi:10.1016/j.ijsu.2009.05.009

Cited by 35 publications

(39 citation statements)

References 20 publications

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“…However, the degree to which varicocele repair improves pregnancy rates and the success of assisted reproductive technology remains controversial. Varicoceles are associated with infertility but the significance of this relationship is uncertain; surgical or radiological repair of varicoceles is not recognized as appropriate treatment for infertility [20,[26][27][28][29] . Scrotal US is used to examine the testes in at least two planes, the transverse and longitudinal; the size is measured and the echotexture is evaluated [30] .…”

Section: Scrotal Us Findings In Non Obstructive Azoospermiamentioning

confidence: 99%

Imaging in male-factor obstructive infertility

Donkol¹

2010

WJR

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The main purpose of imaging evaluation in male infertility is to identify and treat correctable causes of infertility, such as obstruction of the seminal tract. Various imaging modalities are available to evaluate men with obstructive infertility including scrotal ultrasonography, transrectal ultrasound (TRUS), vasography, magnetic resonance imaging, seminal vesicle aspiration, seminal tract washout, and seminal vesiculography. To date the most reliable and accurate diagnostic technique for obstructive infertility is unclear. In this review article, we report the role of these modalities in diagnosis of obstructive infertility. Scrotal sonography is the initial modality, and if patient results indicate non obstructive azoospermia as varicocele or testicular pathology they will be treated according to standard protocols for management of these pathologies. If the patient findings indicate proximal obstructive azoospermia, they can be managed by vasoepididymostomy. If the scrotal ultrasound is normal, TRUS is the second imaging modality. Accordingly, they are classified into patients with criteria of obstructive infertility without urogenital cysts where TRUS-guided aspiration and seminal vesiculography can be performed and transurethral resection of the ejaculatory ducts (TURED) will be the management of choice. In patients with urogenital cyst, TRUS-guided cyst aspiration and opacification are performed. If the cyst is communicating with the seminal tract, management will be transurethral incision of the cyst. If the cyst is not in communication, the obstruction may be relieved after cyst aspiration. If the obstruction is not relieved, TURED will be the management of choice. Sperm harvested during aspiration may be stored and used in assisted reproduction techniques. If the results of TRUS are inconclusive or doubtful, endorectal magnetic resonance imaging should be performed to serve as a "detailed map" for guiding corrective operative interventions.

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Section: Scrotal Us Findings In Non Obstructive Azoospermiamentioning

confidence: 99%

Imaging in male-factor obstructive infertility

Donkol¹

2010

WJR

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“…One study was excluded due to duplication of data in a later paper [7,8]. Another study was excluded because final analysis of outcome detected a subject diagnosed with cryptozoospermia [2]. Altogether 12 studies were included in the review.…”

Section: Resultsmentioning

confidence: 99%

“…Varicocele often results in sperm production disorders marked by the abnormal quality of semen, ranging from oligospermia to azoospermia [2]. Non-obstructive azoospermia was reported at 4.3 to 13.3% in infertile men with clinical varicocele [3].…”

Section: Introductionmentioning

confidence: 99%

“…Nowadays, even though pregnancy can be achieved through a single sperm using intracytoplasmic sperm injection (ICSI), the success rate of ICSI using the motile sperm in ejaculate is higher than that of sperm using testicular sperm extraction (TESE) [2]. Thus, a specific therapy based on the etiopathology has been voted to be the best form of therapy, including varicocele surgery.…”

Section: Introductionmentioning

confidence: 99%

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The role of varicocele repair in non-obstructive azoospermic men: A systematic review

Putra¹,

Birowo²,

Widyahening³

et al. 2016

Kme

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“…Data analyzed in the current study revealed that 538 participants from diverse area in the world, issue from 7 original sources underwent varicocelectomy following by ARTs during the period of 2001-2011; this may be sufficient to assess male infertility due to varicoceles regarding the existing controversies [4,7,14,16,24,25] and based on updated recommendations and guidelines for good practices [3,4,[19][20][21]23]. The mean age of 4 studies showed mid advanced age (34 years old) for men to conceive; most studies suggested the average interval of about 6 months from varicocelectomy to ART [1,24,26,27].…”

Section: Discussionmentioning

confidence: 97%

The Clinical Outcomes of Varicocelectomy and Assisted Reproductive Technology to Treat Men Infertility: A Meta-Analysis

Yuan¹,

Kuété²

2016

Andrology(Los Angel)

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The current study aimed to evaluate the effects of varicocelectomy on semen quality and Assisted Reproductive Technology (ART) clinical outcomes. This meta-analysis was performed using Ovid (Medline, Adis, LWW, Embase; 1974 to 2014 November 10) and the PubMed (until 2014 November 10) databases. Male infertility, varicocelectomy and assisted reproductive technology were required as keywords. Data were analysed with STATA 11.0. Odds Ratio (OR) and 95% Confidence Interval (CI) were used to assess the effects of varicocelectomy on the ART clinical outcomes and funnel plots help to detect publication bias. 538 of 1068 participants issue from 7 original sources from diverse area in the world underwent varicocelectomy followed by ART between 2001 and 2011. Globally, defected semen parameters were improved after varicocelectomy among treated groups in all these studies. Significant improvement in clinical pregnancy (OR=1.76; 95% CI: 1.35-2.29, P<0.0001) and decrease of miscarriage rate (OR=0.65; 95% CI: 0.42-0.99, P=0.042) after ART use-among treated group; and finally, undergo ART specifically Intracytoplasmic Sperm Injection (ICSI) after varicocelectomy may increase live birth among treated group; Although 4 of these studies showed statistical differences, overall, there is no difference to achieve pregnancy among couples who underwent varicocelectomy and followed ART (OR=1.58; 95% CI: 0.82-3.03; P=0.172). Overall, the findings of the study suggested that varicocelectomy improves semen quality and therefore may reduce miscarriages, increase clinical pregnancy and live birth rates of couples who undergo ART specifically ICSI.

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Varicocelectomy in men with nonobstructive azoospermia: Is it beneficial?

Abstract: High ligation varicocelectomy may offer nonobstructive azoospermic men an opportunity to have motile sperm via ejaculate and even the chance of natural conception, instead of the more bothersome assisted reproductive techniques.

Cited by 35 publications

References 20 publications

Imaging in male-factor obstructive infertility

Imaging in male-factor obstructive infertility

The role of varicocele repair in non-obstructive azoospermic men: A systematic review

The Clinical Outcomes of Varicocelectomy and Assisted Reproductive Technology to Treat Men Infertility: A Meta-Analysis

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