Journal of AndrologyVolume 32, Issue 1 p. 1-1 Free Access Pregnancy Rate After Varicocele Repair: How Many Miscarriages? Luciano Negri, Luciano Negri Reproductive Medicine Unit IRCCS Istituto Clinico Humanitas via Manzoni 56, 20086 Rozzano Milano, ItalySearch for more papers by this authorPaolo E. Levi-Setti, Paolo E. Levi-Setti Reproductive Medicine Unit IRCCS Istituto Clinico Humanitas via Manzoni 56, 20086 Rozzano Milano, ItalySearch for more papers by this author Luciano Negri, Luciano Negri Reproductive Medicine Unit IRCCS Istituto Clinico Humanitas via Manzoni 56, 20086 Rozzano Milano, ItalySearch for more papers by this authorPaolo E. Levi-Setti, Paolo E. Levi-Setti Reproductive Medicine Unit IRCCS Istituto Clinico Humanitas via Manzoni 56, 20086 Rozzano Milano, ItalySearch for more papers by this author First published: 02 January 2013 https://doi.org/10.2164/jandrol.110.010850Citations: 2AboutSectionsPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat To the Editor: Your journal has published a review by Çayan et al (2009) on varicocele repair in infertile men. The primary aim of varicocele treatment for subfertility is pregnancy, but no data about live birth rate were available for any of the studies analyzed. This gap has been pointed out by other reviews (Schlegel, 1997; Evers and Collins, 2003) and a search on PubMed, using varicocele (3727 titles) and miscarriage/abortion keywords, resulted in only 1 study (Lukkarinen et al, 1997) on 26 infertile men. These investigators declared 8 spontaneous pregnancies after varicocele repair, with 2 miscarriages. In an attempt to understand the miscarriage rate after varicocele repair, we have retrieved data on 389 infertile couples from our database (October 2005–January 2009; women, median age 34.5 years [range 19.1–41 years]; men, median age 36.5 years [range, 24.1–53.4 years]). All men had some semen anomaly and varicocele surgically corrected, while waiting for assisted reproductive procedures. Diagnosis of varicocele was based on clinical examination and on basal venous reflux in the upright position. All couples respected classic inclusion criteria for male and female pathologies. The follow-up (SE 18.9 ± 0.46 months [range, 9–40 months]) was conducted by chart review and telephone calls/e-mail. One hundred seventeen spontaneous pregnancies were achieved (30%). The spontaneous pregnancy rate results were significantly higher in women aged <35 years (74 of 207; 35.7%) than in women aged ≥35 years (43 of 182; 23.6%; Fisher's exact test, P = .01). Ten miscarriages (<12 weeks) out of 74 pregnancies (13.5%) were recorded in the younger group vs 8 out of 43 (18.6%) in the older group (NS). Therefore, the live birth rates after varicocele repair are 30.9% in women aged <35 years and 19.2% in women aged ≥35 years (P = .01). In conclusion, the miscarriage rate (<12 weeks) after varicocele repair is about 15%, very similar to that observed in the general population (Nybo Andersen et al, 2000). This should be taken into consideration in future reviews or meta-analyses dealing with varicocele repair outcome. References Çayan S., Shavakhabov S., Kadioğlu A.. Treatment of palpable varicocele in infertile men: a meta-analysis to define the best technique. J Androl. 2009; 30: 33– 40. Wiley Online LibraryPubMedWeb of Science®Google Scholar Evers JL, Collins JA. Assessment of efficacy of varicocele repair for male subfertility: a systematic review. Lancet. 2003; 361: 1849– 1852. CrossrefPubMedWeb of Science®Google Scholar Lukkarinen O., Hellström P., Leinonen S., Juntunen K.. Is varicocele treatment useful? Ann Chir Gynaecol. 1997; 86: 40– 44. CASPubMedWeb of Science®Google Scholar Andersen AM Nybo, Wohlfahrt J., Christens P., Olsen J., Melbye M.. Maternal age and fetal loss: population based register linkage study. BMJ. 2000; 320: 1708– 1712. CrossrefCASPubMedWeb of Science®Google Scholar Schlegel PN. Is assisted reproduction the optimal treatment for varicocele-associated male infertility? A cost-effectiveness analysis. Urology. 1997; 49: 83– 90. CrossrefPubMedWeb of Science®Google Scholar Citing Literature Volume32, Issue1January‐February 2011Pages 1-1 ReferencesRelatedInformation