Related Experiment Videos
Preoperative semen analysis as a predictor of seminal improvement following varicocelectomy
T G Matkov1, M Zenni, J Sandlow
1Department of Urology, Rush-Presbyterian-St. Luke's Medical Center, Chicago, Illinois 60612, USA.
Objective:
To determine the predictive role of preoperative semen analysis on both seminal improvement and pregnancy rates following varicocelectomy.
Design:
Retrospective data analysis.
Setting:
Two academic medical center infertility clinics.
Patient(S):
One hundred ten consecutive patients who underwent varicocelectomies. Seminal improvement data were available for 84 patients, and pregnancy data were available for 58 patients.
Intervention(S):
Stratification of patients based on preoperative total motile sperm count (TM). Varicocelectomy was performed on all patients.
Main Outcome Measure(S):
TMs, pregnancy rates, and conception techniques following varicocelectomy of each preoperative group.
Result(S):
Men with mild to moderate oligoasthenospermia (TM >5 million) had significantly better seminal improvement following varicocelectomy. While preoperative stratification showed no difference in pregnancy rates (when assisted reproductive techniques were included), men who achieved a postoperative TM >20 million were more likely to achieve conception by less invasive techniques (natural and intrauterine insemination vs. in vitro fertilization [IVF]).
Conclusion(S):
Varicocelectomy may be the most cost-effective initial intervention in males with TM >5 million. Patients with TM <5 million and concomitant female factor infertility may be better initial candidates for IVF.