Seminal Plasma Clusterin as a Biomarker for Spermatogenesis in Varicocele Patients before and after Varicocelectomy

Abstract

Abstract Introduction a varicocele is an abnormally dilated pampiniform plexus of veins. Hyperthermia, oxidative stress, and elevated apoptotic index have been described in men with variocele and infertility. Clusterin (Clu) is a chaperone-like glycoprotein which is synthesized by Sertoli cells in high concentrations and is deposited onto the membranes of and mature spermatozoa, giving rise to the possibility that it has a role in sperm development. Secreted form of clusterin is a powerful anti-apoptotic. Aim To explore clusterin level in seminal plasma of infertile men with varicocele in comparison to normal healthy fertile subjects and to compare the seminal plasma clusterin level before and after varicocelectomy Methods The study included 25 patients suffering from varicocele with infertility (whether primary or secondary) for 12 months, and 10 healthy volunteers of matched age and sex as control. For all the patients Sub-inguinal varicocelectomy was done. Semen analysis, and seminal plasma clusterin assay were carried out before and three months after varicocelectomy. Results there was a statistically significant difference between patients and controls as regards sperm count, progressive motility, and seminal plasma clusterin (P < 0.01). Three months after varicocelectomy, the sperm count had a highly significant improvement in the patient’s group (Mean= 17.90 + 8.86) compared to a preoperative count (Mean= 11.43 + 7.56). There was a highly significant improvement in post-operative progressive motility in the patient’s group (Mean= 34.5 + 20.2) compared to a preoperative progressive motility (Mean= 22.05 + 15.5). Post-operative clusterin showed a highly significant elevation in the patient’s group postoperative (Mean= 10.73 + 4.5) compared to a preoperative clusterin (Mean= 6.68 + 3.8). Conclusion Based on our study we could suggest another way of contribution of varicocele to male infertility by affecting seminal plasma clusterin level.