MP89-01 TIME TO IMPROVEMENT IN SEMEN ANALYSIS PARAMETERS AFTER VARICOCELECTOMY

Abstract

You have accessJournal of UrologyInfertility: Therapy I1 Apr 2017MP89-01 TIME TO IMPROVEMENT IN SEMEN ANALYSIS PARAMETERS AFTER VARICOCELECTOMY Melissa St.Aubin, Dane Johnson, Kate Cohen, and Jay Sandlow Melissa St.AubinMelissa St.Aubin More articles by this author , Dane JohnsonDane Johnson More articles by this author , Kate CohenKate Cohen More articles by this author , and Jay SandlowJay Sandlow More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.2799AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Varicoceles are the most common identifiable cause of male factor subfertility. The impact of varicocelectomy on pregnancy outcome has been debated. We sought to evaluate the time frame for changes in semen parameters following varicocelectomy and examine the impact on natural conception. METHODS We performed a retrospective chart review on all patients who presented to our Reproductive Medicine Center for male factor subfertility and abnormal semen analysis (SA) parameters. Inclusion criteria were limited to men with clinically palpable varicoceles, who had at least one abnormal semen parameter on pre-operative SA, and had post-operative SA data available at both 3 and 6 months. Patients with at least 50% increase in total progressively motile sperm per ejaculate on their post-operative SA were classified as having improved semen parameters after varicocelectomy. Pregnancy outcomes were gathered retrospectively, and successful pregnancy was defined as live birth after intrauterine insemination or spontaneous pregnancy. RESULTS A total of 126 patients who underwent sub-inguinal varicocelectomy between 2006 and 2015 were included in this study. Following varicocelectomy, 72 patients (57%) had improvement in semen parameters. Spontaneous pregnancy or pregnancy from intrauterine insemination was more likely to occur in patients who had improved SA parameters (31% vs 10% p = 0.004). Of the patients that improved, 50 patients (69%) did so by 3 months. Another 22 patients (31%) saw eventual improvement in SA parameters by 6 months post-operative. There was no statistically significant difference in pregnancy outcomes between early improvement and delayed improvement in SA parameters ( 26% vs 41% respectively, p = 0.21). CONCLUSIONS Varicocelectomy resulted in a significant improvement in semen parameters in half of our patients. Of these, the majority who improved did so by 3 months post procedure; however, ~30% of patients without improvement at 3 months subsequently improved at 6 months. Pregnancy rates were statistically higher in patients who had >50% increase in total progressive motile sperm, regardless of the time it took to see this improvement. This data may be useful in counseling couples post varicocelectomy as to the time course for improvement and pregnancy outcomes. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e1202 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Melissa St.Aubin More articles by this author Dane Johnson More articles by this author Kate Cohen More articles by this author Jay Sandlow More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...