The Effect of Varicocelectomy on the Pregnancy Rate in Patients with Severe Oligospermia

Varicocele is the most common correctable cause of male infertility. But, it is still controversial in patients with severe oligospermia.

The aim of this study is to evaluate how varicocelectomy impacts pregnancy rates (natural or assisted reproductive techniques) in infertile couples when the male partner has severe oligospermia and history of varicocele.

A retrospective examination was made of males with total motile sperm count <5 million/mL with varicocele in the period April 2013 to October 2019. Pregnancy rates were compared at the end of 1-year follow-up of 52 patients (Group 1) who underwent varicocelectomy and 36 patients (Group 2) who applied for assisted reproductive techniques without surgery. The postoperative third-month sperm parameters were compared for Group 1. Spontaneous pregnancy and conception rates with assisted reproductive techniques for Groups 1 and 2 were also investigated after 1 year.

In the semen analysis performed in the 3^rd month, a statistically significant increase was observed in sperm number, motility, and morphology of the patients in Group 1. Spontaneous pregnancy was obtained in 7 (13.4%) of the 56 Group 1 patients who underwent varicocelectomy, in 7 (13.4%) patients with intrauterine insemination, and in 6 (11.5%) patients with intracytoplasmic injection (ICSI). In Group 2, pregnancy occurred with the help of ICSI in 4 of 32 patients (11.1%).

Varicocele surgery before assisted reproductive techniques will be more beneficial in terms of both cost-effectiveness and pregnancy rates.