MP26-01 LARGER VARICOCELES ARE ASSOCIATED WITH HIGHER SPERM DNA FRAGMENTATION INDICES

Abstract

You have accessJournal of UrologyInfertility: Epidemiology & Evaluation I (MP26)1 Apr 2020MP26-01 LARGER VARICOCELES ARE ASSOCIATED WITH HIGHER SPERM DNA FRAGMENTATION INDICES Graham Machen*, Melissa Gilkey, Shahryar Kavoussi, Caitlin Hunn, Shu-Hung Chen, J. David Wininger, and Parviz Kavoussi Graham Machen*Graham Machen* More articles by this author , Melissa GilkeyMelissa Gilkey More articles by this author , Shahryar KavoussiShahryar Kavoussi More articles by this author , Caitlin HunnCaitlin Hunn More articles by this author , Shu-Hung ChenShu-Hung Chen More articles by this author , J. David WiningerJ. David Wininger More articles by this author , and Parviz KavoussiParviz Kavoussi More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000865.01AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Varicoceles are a well established cause of sperm DNA damage; while the mechanism is not entirely clear, it is believed to be mediated through elevations in reactive oxygen species and decreases in antioxidant capacity. Despite this association, not every varicocele leads to deleterious degrees of sperm DNA damage, making it a challenge to identify who should be assessed with a DNA fragmentation index (DFI). Some evidence exists that larger varicoceles may result in more profound testicular dysfunction and subsequent semen parameter impairment. However, similar studies analyzing the effect of varix size on degree of sperm DNA damage are sparse. Thus, we set out to further characterize this relationship. METHODS: A retrospective chart review was undertaken to identify men with varicoceles who had semen analyses including DFI as part of an evaluation for subfertility from January 1, 2016 to October 15, 2019 in a single fertility center. DFI was measured using a sperm chromatin dispersion assay with a DFI of 27 as the upper limit of normal. Varix grade (I-III) was assigned in accordance with physical examination findings. Subclinical varicoceles were excluded from the analysis. RESULTS: A total of 166 patients were identified; the mean age was 33.57 (SD 6.16) and BMI was 27.61 (SD 5.78). Sixty-three patients had a grade 3 varicocele, 90 had a grade 2, and 13 had a grade 1. Eleven patients had bilateral varicoceles (categorized by larger varicocele), while the remaining patients were unilateral. The mean abstinence interval for the entire cohort prior to semen analysis was 3.30 d (SD 1.0). See table 1 for summary of results comparing demographic characteristics and semen parameters, including DNA fragmentation, for Grade 1-2 and Grade 3 varicoceles. CONCLUSIONS: Our results suggest larger, grade III varicoceles are associated with a statistically significantly higher DFI relative to smaller (grades I and II) varicoceles. Of note, while sperm concentration and total motile counts were both less in men with grade 3 varicoceles, these parameters did not reach statistical significance. Further studies are needed to more conclusively determine this relationship, and to assess the degree of improvement in DFI after surgery stratified by varix grade. Source of Funding: none © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e400-e400 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Graham Machen* More articles by this author Melissa Gilkey More articles by this author Shahryar Kavoussi More articles by this author Caitlin Hunn More articles by this author Shu-Hung Chen More articles by this author J. David Wininger More articles by this author Parviz Kavoussi More articles by this author Expand All Advertisement PDF downloadLoading ...