Subinguinal microsurgical varicocelectomy for male factor subfertility: ten-year experience

Area of Science:

• Urology
• Reproductive Medicine
• Andrology

Background:

• Varicoceles are a common cause of male infertility.
• Subinguinal microsurgical varicocelectomy is a surgical technique to address varicoceles.
• Male factor subfertility affects a significant number of couples seeking fertility treatment.

Purpose of the Study:

• To evaluate the effectiveness of subinguinal microsurgical varicocelectomy.
• To assess the impact on semen parameters (sperm concentration, motility, morphology).
• To determine the effect on pregnancy outcomes in couples with male factor subfertility.

Main Methods:

• Retrospective case series of 42 male patients with subfertility and palpable varicoceles.
• Semen analyses performed pre- and post-operatively according to World Health Organization criteria.
• Pregnancy outcomes documented, including spontaneous and assisted reproductive technologies.

Main Results:

• Significant improvements observed in sperm concentration (12 to 23 million/mL), motility (26% to 32%), and morphology (5% to 6%) post-surgery (P<0.001).
• Overall pregnancy rate of 55% (23/42), with 26% (11/42) spontaneous pregnancies.
• In patients with severe oligospermia (<5 million/mL), 25% achieved spontaneous pregnancy with significant semen parameter improvements.

Conclusions:

• Subinguinal microsurgical varicocelectomy is an effective treatment for male factor subfertility associated with varicoceles.
• The procedure leads to improved semen quality and increased likelihood of pregnancy, including spontaneous conception.
• This surgical approach offers a valuable option for couples facing infertility due to varicoceles.