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Lamy SH, Mohammedkhalil AK, Bafaqeeh HM, Alsuwaida SA, Alhindi ASK, Maqboli SA, Khan MA. Efficacy of varicocelectomy on semen parameters and conception rates. Urol Ann 2023; 15:256-260. [PMID: 37664101 PMCID: PMC10471810 DOI: 10.4103/ua.ua_49_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 12/08/2022] [Indexed: 09/05/2023] Open
Abstract
Objective Varicocele, the dilation of the pampiniform plexus of the spermatic cord. It is discovered incidentally in most patients. Symptoms vary, but its impact is especially experienced in the field of fertility and reflected in semen parameters. Varicocelectomy is a surgical approach to correct the varicocele, however, reports are conflicting regarding its success. Our aim was to evaluate the efficacy of varicocelectomy on semen parameters and conception rates in patients who underwent surgery and its association with comorbidities such as diabetes, hypertension, and obesity. Materials and Methods This cross-sectional study included the complete medical records of 86 patients. Data collection form included the patient's age, body mass index (BMI), chronic diseases, smoking, surgical history, medication usage, and the reason for performing surgery. Presurgical and postsurgical semen parameters were evaluated 3 months before surgery and an average of 6 months postoperatively. Data were analyzed with SPSS, Chi-square test, and independent and paired t-test. Results No significant difference was found between primary and secondary infertility regarding semen analysis, postoperative semen analysis indicated an improvement in semen motility at 180 min with no effect on other parameters. Using spontaneous intercourse or in vitro fertilization (IVF) after varicocelectomy was significantly associated with increasing conception rates irrespective of the type of infertility. Diabetes, hypertension, BMI, and smoking did not appear to affect semen parameters. Conclusion Patients who underwent varicocelectomy had improved sperm motility at 180 min and subsequently had a higher chance of successful conception either through spontaneous intercourse or IVF. Further studies are needed to understand the relationship between conception and sperm motility. Semen parameters were not affected if the patient had comorbidities such as diabetes and hypertension. Furthermore, smoking and BMI did not appear to affect the conception rate.
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Affiliation(s)
- Salahadin H Lamy
- Department of Surgery, Urology Section, King Khalid National Guard Hospital, King Abdulaziz Medical City, Jeddah, Saudi Arabia
- Department of Surgery, Urology Section, College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Abdullah K Mohammedkhalil
- Department of Surgery, Urology Section, King Khalid National Guard Hospital, King Abdulaziz Medical City, Jeddah, Saudi Arabia
- Department of Surgery, Urology Section, College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Hashim M Bafaqeeh
- Department of Surgery, Urology Section, College of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Shatha A Alsuwaida
- Department of Surgery, Urology Section, College of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Adel S Khan Alhindi
- Department of Surgery, Urology Section, College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Sara A Maqboli
- Department of Surgery, Urology Section, College of Medicine, Batterjee Medical College, Jeddah, Saudi Arabia
| | - Muhammad A Khan
- Department of Surgery, Urology Section, College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
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Senturk AB, Cakiroglu B, Yaytokgil M, Aydin C, Sungur M, Akkoc A. Effect of venous reflux time on testosterone and semen parameters of infertile males after microscopic varicocelectomy. Andrologia 2020; 52:e13583. [PMID: 32271466 DOI: 10.1111/and.13583] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 03/04/2020] [Accepted: 03/10/2020] [Indexed: 12/01/2022] Open
Abstract
This study aimed to search whether there is a link between reflux flow and hormonal profile. Data of 250 patients were retrospectively investigated. Pre-operative and 6th month semen analyses of these patients' results were compared with pre-operative and post-operative 6th month serum levels of testosterone. Based on the venous flow on pre-operative Doppler ultrasonography, patients were divided into two groups. Patients with a venous flow ≤4 s were assigned to Group 1 and those with a venous flow >4 s to Group 2. Venous reflux time cut-off was calculated as 4 s using ROC curve according to the increase in testosterone level. When venous reflux time was selected as approximately 4.0 s, ROC had 79.8% sensitivity and 72.8 specificity. The probability of a post-operative increase in testosterone is high in patients with a venous reflux time longer than 4 s.
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Affiliation(s)
| | - Basri Cakiroglu
- Department of Urology, Hisar Intercontinental Hospital, Istanbul, Turkey
| | - Muhammet Yaytokgil
- Department of Urology, Hitit Universitesity Corum Training and Research Hospital, Corum, Turkey
| | - Cemil Aydin
- Department of Urology, Hitit University, Corum, Turkey
| | - Mustafa Sungur
- Department of Urology, Hitit Universitesity Corum Training and Research Hospital, Corum, Turkey
| | - Ali Akkoc
- Department of Urology, Alanya Alaattin Keykubat University, Alanya, Turkey
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Rezaei-Agdam H, Moshari S, Nahari E, Minas A, Daliri Z, Hallaj M, Razi M. Zeta and hyaluronic acid assessments, novel sperm selection procedures, in animal model for male infertility. Andrologia 2019; 51:e13447. [PMID: 31617612 DOI: 10.1111/and.13447] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 08/18/2019] [Accepted: 08/26/2019] [Indexed: 12/16/2022] Open
Abstract
Considering varicocele (VCL)-induced severe, progressive DNA damage, histone-protamine anomalies and low sperm production, in the current study, the experimental VCL was induced and the efficiency of hyaluronic acid (HA)-binding method (HABM) and zeta preparation procedure (ZPP) in selection of appropriate spermatozoa was compared with those spermatozoa from intact animals. Following 2 and 4 months, the histological alterations in testicular tissue, sperm count and viability were assessed to prove the VCL condition. The spermatozoa were undergone simple wash, HABM and ZPP. The chromatin condensation, active caspase-3 expression, DNA fragmentation and apoptosis index were analysed after applying selection techniques and compared with the spermatozoa from intact and VCL-induced animals, which were undergone a simple wash. Observations showed that both HABM and ZPP effectively prepared the spermatozoa with higher chromatin condensation and lower DNA damage. Meanwhile, the ZPP exerted a more preferable effect by preparing the spermatozoa with higher chromatin condensation, and lower caspase-3 expression, and DNA disintegrity versus the HABM, especially after 4 months. In conclusion, ZPP seems to exert much more reliable efficiency in selecting appropriate spermatozoa for ICSI processes, while more studies are needed to find out which one is more useful in the clinical assisted reproductive technique (ART) process.
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Affiliation(s)
- Hamed Rezaei-Agdam
- Molecular and Genetic Division, Rasta Diagnostic and Research Center, Urmia, Iran
| | - Sana Moshari
- Division of Histology and Embryology, Department of Basic Science, Faculty of Veterinary Medicine, Urmia University, Urmia, Iran
| | - Elaheh Nahari
- Molecular and Genetic Division, Rasta Diagnostic and Research Center, Urmia, Iran
| | - Aram Minas
- Division of Histology and Embryology, Department of Basic Science, Faculty of Veterinary Medicine, Urmia University, Urmia, Iran
| | - Zeynab Daliri
- Department of Biology, Faculty of Sciences, Islamic AZAD University, Science and Research Branch, Tehran, Iran
| | - Mahsa Hallaj
- Division of Histology and Embryology, Department of Basic Science, Faculty of Veterinary Medicine, Urmia University, Urmia, Iran
| | - Mazdak Razi
- Division of Histology and Embryology, Department of Basic Science, Faculty of Veterinary Medicine, Urmia University, Urmia, Iran
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Ariagno JI, Mendeluk GR, Furlan MJ, Sardi M, Chenlo P, Curi SM, Pugliese MN, Repetto HE, Cohen M. Computer-aided sperm analysis: a useful tool to evaluate patient's response to varicocelectomy. Asian J Androl 2018; 19:449-452. [PMID: 27101803 PMCID: PMC5507091 DOI: 10.4103/1008-682x.173441] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Preoperative and postoperative sperm parameter values from infertile men with varicocele were analyzed by computer-aided sperm analysis (CASA) to assess if sperm characteristics improved after varicocelectomy. Semen samples of men with proven fertility (n = 38) and men with varicocele-related infertility (n = 61) were also analyzed. Conventional semen analysis was performed according to WHO (2010) criteria and a CASA system was employed to assess kinetic parameters and sperm concentration. Seminal parameters values in the fertile group were very far above from those of the patients, either before or after surgery. No significant improvement in the percentage normal sperm morphology (P = 0.10), sperm concentration (P = 0.52), total sperm count (P = 0.76), subjective motility (%) (P = 0.97) nor kinematics (P = 0.30) was observed after varicocelectomy when all groups were compared. Neither was significant improvement found in percentage normal sperm morphology (P = 0.91), sperm concentration (P = 0.10), total sperm count (P = 0.89) or percentage motility (P = 0.77) after varicocelectomy in paired comparisons of preoperative and postoperative data. Analysis of paired samples revealed that the total sperm count (P = 0.01) and most sperm kinetic parameters: curvilinear velocity (P = 0.002), straight-line velocity (P = 0.0004), average path velocity (P = 0.0005), linearity (P = 0.02), and wobble (P = 0.006) improved after surgery. CASA offers the potential for accurate quantitative assessment of each patient's response to varicocelectomy.
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Affiliation(s)
- Julia I Ariagno
- Clinical Biochemistry Department, Male Fertility Laboratory, Faculty of Pharmacy and Biochemetry, University of Buenos Aires, Argentina
| | - Gabriela R Mendeluk
- Clinical Biochemistry Department, Male Fertility Laboratory, Faculty of Pharmacy and Biochemetry, University of Buenos Aires, Argentina
| | - María J Furlan
- Clinical Biochemistry Department, Male Fertility Laboratory, Faculty of Pharmacy and Biochemetry, University of Buenos Aires, Argentina
| | - M Sardi
- Clinical Biochemistry Department, Male Fertility Laboratory, Faculty of Pharmacy and Biochemetry, University of Buenos Aires, Argentina
| | - P Chenlo
- Clinical Biochemistry Department, Male Fertility Laboratory, Faculty of Pharmacy and Biochemetry, University of Buenos Aires, Argentina
| | - Susana M Curi
- Clinical Biochemistry Department, Male Fertility Laboratory, Faculty of Pharmacy and Biochemetry, University of Buenos Aires, Argentina
| | - Mercedes N Pugliese
- Clinical Biochemistry Department, Male Fertility Laboratory, Faculty of Pharmacy and Biochemetry, University of Buenos Aires, Argentina
| | - Herberto E Repetto
- Clinical Biochemistry Department, Male Fertility Laboratory, Faculty of Pharmacy and Biochemetry, University of Buenos Aires, Argentina
| | - Mariano Cohen
- Urology Department, "José de San Martín" Clinical Hospital, University of Buenos Aires, Buenos Aires, Argentina (CP1120)
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