Elsevier

Urology

Volume 86, Issue 2, August 2015, Pages 273-275
Urology

Infertility
Efficacy of Varicocele Repair in Different Age Groups

https://doi.org/10.1016/j.urology.2015.05.004Get rights and content

Objective

To compare semen parameters and spouse pregnancy rates after varicocele repair in 2 age groups.

Materials and Methods

Mean changes in spermatozoa concentration, motility, and morphology after varicocele repair in 83 patients were compared between patients aged 30 years or younger (group 1) and those older than 30 years (group 2). Spouse pregnancy rates were compared between the 2 age groups.

Results

The mean sperm concentration increased significantly in both groups (P <.05). The percentage of motile sperm increased from 48.2% to 56.6% in group 1 and from 47.2% to 53.2% in group 2 one year after varicocele repair. The increase in motility was statistically significant for both groups (P <.05), but there was no statistically significant difference in the increase in sperm motility between the 2 groups (P = .01). The percentage of sperm with abnormal morphology decreased significantly in both groups 12 months postoperatively (from 62.7% to 59.6% in group 1 and from 61.3% to 58% in group 2; P = .03). However, there was no statistically significant difference in the improvement in sperm morphology between the 2 groups (P >.05). The pregnancy rates in the patients' spouses were 51.1% and 44.7% in groups 1 and 2, respectively. This difference was not statistically significant (P = .9).

Conclusion

There was no statistically significant difference in semen parameter improvement and spouse pregnancy rates after varicocelectomy in the 2 age groups.

Section snippets

Materials and Methods

During March 2012 to March 2013, this study was performed in Al-Zahra Hospital, Isfahan, Iran.

The Committee of Ethics approved the protocol, and patients signed an informed consent before joining the study.

We prospectively studied a cohort of 100 primary infertility patients aged 20-50 years who had 1-sided (left) varicocele and an abnormality in at least 1 semen parameter (concentration, motility, and morphology) based on World Health Organization reference values.11 Sample size of 42 patients

Results

Mean patient and spouse ages were 30 and 26 years, respectively. Mean sperm concentrations in group 1 (≤30 years) were 40.2, 57.1, and 68.1 million/mL before, 6 months, and 12 months after varicocele repair. Mean sperm concentrations in group 2 (>30 years) were 49.7, 53.7, and 58.4 million/mL before, 6 months, and 12 months after varicocele repair. The increase in sperm concentration was statistically significant in both groups (P <.001). Moreover, the increase in sperm concentration in group 1

Comment

The objective of this study was to compare the effects of varicocelectomy on semen parameters and spouse pregnancy rates in 2 groups of primary infertility patients with varicocele (≤30 years and >30).

In the study by Grasso et al12 in 2000, varicocelectomy had no significant effects on semen parameters and spouse pregnancy in patients >30 years.

In the present study, sperm concentration increased significantly in both age groups after varicocelectomy (P <.001). The study by Evers et al,13 too,

Conclusion

There was no statistically significant difference in semen parameter improvement and spouse pregnancy rates after varicocele repair in the 2 groups (≤30 years and >30 years). Varicocele repair can thus be recommended for older patients if indicated.

Cited by (9)

  • An examination on composition of spermatozoa obtained from pre-operative and post-operative varicocele patients

    2018, Reproductive Biology
    Citation Excerpt :

    Infertility is defined as the failure to conceive after at least one year of unprotected sexual intercourse due to issue in either the male or female [2]. Varicocele is one of the main and surgically repairable causes of male infertility due to valve failure, extensive dilatation, and torsion of the testicular veins in the plexus pampiniformis, and has been identified in 15–20% of adult males, 35–40% of males with primary infertility and 60–80% of males with secondary infertility [3–5]. Various studies have been carried out to investigate the mechanism by which varicocele causes infertility, and studies to date have suggested that increased testicular temperatures due to impaired micro circulation with a reflow of the blood in the testicular veins back into the testis, the accumulation of high amounts of certain metabolites and reduced oxygenation in dilated veins are all potential factors in the decreased count and impaired motility, morphological and chromosomal structure of spermatozoa associated with impaired fertilization capacity [5,6].

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Financial Disclosure: The authors declare that they have no relevant financial interests.

Funding Support: This study was financially supported by a grant from the vice chancellor for research, Isfahan University of Medical Sciences (grant no. 753624).

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