[Bilateral microsurgical varicocelectomy in infertile men]

Area of Science:

• Urology
• Andrology
• Reproductive Medicine

Background:

• Varicocele is a common cause of male infertility.
• Bilateral varicocele affects semen quality and spermatogenesis.
• Microsurgical varicocelectomy is a treatment option for varicocele-associated infertility.

Purpose of the Study:

• To assess the impact of bilateral microsurgical varicocelectomy on semen quality in infertile men with bilateral varicocele.
• To investigate spermatogenesis failure through testicular biopsy.
• To determine if the procedure alters candidacy for assisted reproductive technology (ART).

Main Methods:

• A cohort of 198 infertile men with bilateral varicocele underwent microsurgical varicocelectomy and bilateral testicular biopsy.
• Semen analyses and hormone status were evaluated pre- and post-operatively.
• Patients were categorized into biological groups based on sperm count and qualified for different ART methods.

Main Results:

• Postoperative sperm concentration significantly increased in 53.1% of patients.
• The total motile sperm count per ejaculation increased substantially, improving ART eligibility.
• Testicular biopsy revealed various spermatogenesis disturbances, aiding in treatment policy elaboration.

Conclusions:

• Microscopic varicocelectomy is a safe and effective procedure with minimal morbidity and recurrence.
• Simultaneous testicular biopsy aids in defining spermatogenesis disturbances and guiding treatment.
• Improved sperm quality post-varicocelectomy enhances ART success rates and spontaneous pregnancy potential.