Nomogram for Predicting Semen Parameters Improvement after Microscopic Varicocelectomy in Infertile Men with Abnormal...

Area of Science:

• Urology
• Reproductive Medicine
• Surgical Outcomes Research

Background:

• Limited and conflicting data exist on predicting semen parameter improvement post-varicocelectomy.
• Microscopic varicocelectomy (MSV) is a common treatment for male infertility.
• Predictive tools are needed for patient selection and outcome expectation.

Purpose of the Study:

• To develop and validate a nomogram for predicting semen parameter improvement after MSV.
• To identify key factors influencing post-varicocelectomy semen quality.
• To aid in personalized preoperative treatment planning for varicocele.

Main Methods:

• Retrospective analysis of 460 infertile men undergoing MSV (Jan 2018-Dec 2021).
• Development cohort (n=336) and validation cohort (n=124) utilized.
• Multivariate logistic regression and likelihood ratio tests for model creation and validation.

Main Results:

• Initial total progressively motile sperm count (TPMSC) and vein diameter were significant predictors.
• The nomogram showed strong discrimination (AUROC 0.925) and calibration in the validation cohort.
• Clinical utility was confirmed through decision curve analysis.

Conclusions:

• Higher initial TPMSC and larger vein diameter significantly predict improved semen parameters post-MSV.
• The developed nomogram facilitates individualized treatment decisions for varicocele.
• This tool may enhance therapeutic outcomes for infertile men undergoing MSV.