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Sperm ultramorphology as a pathophysiological indicator of spermatogenesis in males suffering from varicocele
M Reichart1, F Eltes, Y Soffer
1Male Fertility Laboratory, Faculty of Life Sciences, Bar-Ilan University, Ramat Gan, Israel.
Insights
Varicocele, a cause of male infertility, significantly impacts sperm quality. High ligation surgery improves sperm density, motility, and morphology, particularly head and acrosome defects.
Area of Science:
- Reproductive Medicine
- Urology
- Andrology
Background:
- Varicocele is a leading cause of male infertility, often linked to reduced sperm quality.
- The exact pathophysiology of varicocele-induced infertility remains unclear.
- Sperm ultramorphology alterations are observed in varicocele patients.
Purpose of the Study:
- To elucidate varicocele pathophysiology by identifying semen parameters that improve post-surgery.
- To assess the impact of high spermatic vein ligation on sperm ultramorphology.
- To correlate specific sperm defects with varicocele and surgical outcomes.
Main Methods:
- Prospective study of 75 males with diagnosed varicocele undergoing high ligation.
- Semen analysis including light microscopy, biochemistry, and quantitative ultramorphology before and 3-9 months after surgery.
- Control group of 25 untreated varicocele patients with repeated semen analysis.
Main Results:
- Treated patients showed significant improvements in sperm density, progressive motility, and normal morphology.
- Post-surgery, improvements were noted in sperm acrosome formation, chromatin condensation, and reduced amorphous heads.
- No significant changes were observed in sperm tail subcellular organelles after treatment.
Conclusions:
- Varicocele can negatively affect early spermatid head differentiation during spermiogenesis.
- Patients with significant sperm acrosome and nucleus malformations benefit from varicocele correction.
- High ligation surgery is effective in improving specific sperm quality parameters affected by varicocele.
Abstract:
Varicocele of spermatic veins is considered to be one of the major causes of male infertility associated with reduction of sperm quality. The pathophysiology of this condition is not yet completely understood. The aim of this study was to shed light on the pathophysiology of varicocele by identifying semen parameters, especially sperm ultramorphology, which improve following high ligation of the spermatic vein. Seventy-five males with diagnosed varicocele were included in this study. Semen parameters were assessed prospectively using light microscopy, semen biochemistry and sperm quantitative ultramorphological analysis, before high ligation and 3-9 months after high ligation. The control group consisted of twenty-five untreated varicocele patients who underwent two semen examinations within 3-9 months. No statistical difference in any of the examined variables was found between the two examinations in the control group. The treated patients exhibited a significant improvement in sperm density, progressive motility, percentage of normally formed spermatozoa, agenesis of sperm acrosome, chromatin condensation and incidence of amorphous heads compared with the pretreatment condition (P < or = 0.01). In contradiction, no significant improvement was observed following treatment in any of the sperm tail subcellular organelles. It is concluded that varicocele may cause deleterious alterations in early spermatid head differentiation during spermiogenesis and that varicocele patients with a high incidence of sperm acrosome and nucleus malformations are appropriate candidates for varicocele correction.