P-035 Effect of Varicocelectomy on normal semen in patients undergoing the procedure for indications other than fertility: evidence needed for counseling

Abstract

Abstract Study question Does microsurgical varicocelectomy impact normal semen parameters in fertile patients undergoing the procedure for indications other than infertility? Summary answer Micro surgical varicocelectomy does not alter the fertility potential of men with normal semen. What is known already Varicocele repair results in improvement in semen parameters and fertility potential in sub fertile patients with clinical varicocele. However, the procedure is also offered to patients with indications other than infertility including testicular pain, testicular size affection, or before army recruitment. Queries about the effect of varicocelectomy on fertility potential in this patient population have been raised but unfortunately not strongly backed by literature. Study design, size, duration A retrospective study of 1521 patients who underwent microsurgical sub inguinal varicocelectomy in our center from 2011–2021. Participants/materials, setting, methods A total of 435 patients with normal semen parameters and underwent varicocelectomy for indications other than infertility were included. Exclusion criteria were patients with infertility, abnormal semen parameters, and prior varicocelectomy. Patient demographics, clinical and laboratory data were collected. Semen analysis (WHO 5th edition), sperm DNA fragmentation (Halosperm) & hormonal assay were performed pre-operative and up to 6 months post-operative. Data were compared using Wilcoxon Signed Ranked Test. A p value <0.05 was considered significant. Main results and the role of chance The mean age was 32.8±7.7 years. Varicocelectomy was performed on left side in 373 patients and bilateral in 62 patients. The majority of the study population had grade III varicocele on the left side. There were no statistically significant changes in semen volume, concentration, total & progressive motility, sperm DNA fragmentation, and hormonal profile after 6 months post varicocelectomy in comparison to initial baseline parameters (table 1). Only a statistically significant improvement in morphology was observed. Limitations, reasons for caution The main limitation is the retrospective design of the study. Long-term effect and conception rate were not evaluated. Wider implications of the findings Results of this work are beneficial during preoperative counseling of patients with normal semen undergoing varicocelectomy for non-fertility indications. Patients can be reassured that the procedure would not affect their fertility potentials negatively. Trial registration number not applicable