Adolescent microsurgical varicocelectomy and changes in sperm parameters: A matched cohort analysis

Area of Science:

• Urology
• Andrology
• Reproductive Medicine

Background:

• Varicocele is a common cause of impaired semen parameters and infertility in adult men.
• The impact of varicocele on semen quality in adolescents and young adults (AYA) is less understood.

Purpose of the Study:

• To evaluate semen parameter improvements after varicocelectomy in the AYA population.
• To compare these improvements with matched adult patients.
• To investigate the benefits of early varicocele intervention.

Main Methods:

• Retrospective analysis of a surgical database (2012-2023).
• Inclusion of AYA men (under 25) and adult men (over 30) who underwent varicocelectomy.
• Matching of AYA and adult groups based on preoperative follicle-stimulating hormone (FSH) and varicocele grade.
• Pre- and post-operative semen analysis (sperm count, motility, morphology).

Main Results:

• Adolescents and Young Adults (AYA) showed greater post-varicocelectomy improvements than the adult cohort.
• Postoperative sperm concentration increased 1.7-fold in AYA men compared to adults (p < 0.001).
• Motility significantly improved in AYA men, with a 2.25-fold increase in total motile sperm count (TMSC) (p = 0.002).

Conclusions:

• Varicocelectomy is a beneficial treatment for AYA with varicocele and impaired semen parameters.
• Early intervention in AYA can lead to substantial improvements in semen quality.
• Considering varicocelectomy for younger individuals may help prevent future fertility issues.