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Oct 25, 2021Keywords:
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Serum reproductive hormone profiles and semen characteristics of infertile men with clinical varicocoeles before and after varicocoelectomy: A prospective cohort study
Abstract
[Accepted Research Article]
Background: Varicocoele had been shown to affect fertility by inducing Leydig cell and Sertoli cell dysfunction in the testes leading to abnormal reproductive hormone values and impairment of spermatogenesis. Varicocoele is a significant risk factor for androgen deficiency and infertility. The aim was to evaluate the early outcome of open subinguinal varicocoelectomy on the serum hormonal parameters and semen parameters in infertile men.
Methods: Forty-five infertile men with varicocoele had serum hormone levels and seminal fluid analysis measured preoperatively at recruitment time and 3 months and 6 months post varicocoelectomy.
Results: The mean age was 34.6 ± 3.1 years. The known duration of inability to achieve conception ranged from 1-7 years with a median duration of 3 years and an interquartile range of 2-4 years. Most of the patients, 37 (82.2%) had primary infertility. 33 (73.3%) men had bilateral varicocoele.
Although the reproductive hormone parameters were all within normal limits, the testosterone levels significantly increased at 6 months after varicocoelectomy (p < 0.001). A significant increase in the testosterone level was found in males with low normal testosterone level (<4ng/ml). There was a significant decrease in serum FSH post varicocoelectomy (p < 0.001). The sperm concentration and progressive motility showed significant increase at 6 months (p < 0.001 respectively).
The pre-operative varicocoele laterality or grade did not affect changes in serum reproductive hormone parameters and changes in semen characteristics.
Conclusions: Open subinguinal varicocoelectomy significantly increases the serum testosterone. The increment is more in men with preoperative low-normal testosterone and a mean total testicular volume of 26.6mL. Varicocoelectomy also improves the spermatogenic function of the testis.
