Abstract
BackgroundThe value of varicocele repair and the latter's impact on semen parameters are still subject to debate.MethodsWe analyse changes over time in initially abnormal sperm parameters and serum concentrations of testosterone, FSH and inhibin B after embolization treatment of males with high-grade varicocele. From 2007 to 2012, we recruited 47 male infertile patients with clinically visible left varicocele in the resting patient and at least one abnormal semen parameter. Sperm parameters and serum levels of total testosterone, FSH and inhibin B were measured prior to retrograde embolization (M0) and then 3 (M3) and 6 (M6) months afterwards.ResultsAt M0, the median sperm concentration was 5.78 [0.84-37.70] × 106/ejaculate. The mean ± SD sperm progressive motility, vitality and percentage of normal sperm were respectively, 21.83 ± 16.48%, 61.88 ± 15.98% and 12.88 ± 7.15%. The corresponding values at M3 were significantly higher (38.75 [3.96-95] × 106/ejaculate, 29.32 ± 14.21%, 69.14 ± 14.86% and 19.03 ± 11.02%, respectively). The mean percentage of spermatozoa with a thin head was significantly lower at M6 (6.35 ± 5.29%) than at M0 (14.03 ± 13.09%). The mean serum testosterone, FSH and inhibin B levels did not change significantly over time.ConclusionsEmbolization treatment in men with clinically visible left varicocele, abnormal sperm parameters and documented infertility is associated with a significant improvement in semen parameters including sperm head morphology.
Highlights
L’intérêt du traitement de la varicocèle clinique et son impact sur les paramètres spermatiques sont de nos jours toujours débattus
Despite heterogeneity in patient characteristics, diagnostic criteria, treatment methods and treatment outcomes, most researchers have found that varicocele repair is associated with a significant improvement in the sperm concentration and progressive motility [4]
Inclusion criteria Male outpatients were recruited by the Department of Andrology at Lille University Hospital between March 2007 and June 2012, according to the French Urology Society's criteria for varicocele and male infertility [1]: documented infertility for more than 1 year, clinically visible left varicocele in the resting patient and at least one abnormal semen parameter in the initial semen analysis [13]: a sperm concentration
Summary
L’intérêt du traitement de la varicocèle clinique et son impact sur les paramètres spermatiques sont de nos jours toujours débattus. Methods: We analyse changes over time in initially abnormal sperm parameters and serum concentrations of testosterone, FSH and inhibin B after embolization treatment of males with high-grade varicocele. The mean serum testosterone, FSH and inhibin B levels did not change significantly over time. Conclusions: Embolization treatment in men with clinically visible left varicocele, abnormal sperm parameters and documented infertility is associated with a significant improvement in semen parameters including sperm head morphology. Despite heterogeneity in patient characteristics, diagnostic criteria, treatment methods and treatment outcomes, most researchers have found that varicocele repair is associated with a significant improvement in the sperm concentration (in 15 out of 22 studies) and progressive motility (in 12 out of 17 studies) [4]. There is controversy over the nature and significance of serum hormone levels (and inhibin B levels) after varicocele repair [10,11,12]
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