Correlation of 17-OH Progesterone Changes With Semen Parameters and Pregnancy Outcomes in Hypogonadal and Eugonadal Patients After Varicocelectomy

To evaluate the impact of varicocele repair on serum 17-OH progesterone (17-OHP) levels and investigate its relationship with semen parameters and pregnancy outcomes in hypogonadal and eugonadal patients. Additionally, to address the unclear association between varicocele and serum 17-OHP levels in male infertility.

This prospective study included 135 men who underwent microscopic subinguinal varicocelectomy. Pre-operative and post-operative (3-6 months) hormone levels, including follicle-stimulating hormone, luteinizing hormone, total testosterone (TT), and 17-OHP, and semen parameters, such as total motile sperm count (TMS) and sperm morphology, were analyzed. Patients were categorized as hypogonadal (TT <300 ng/dL) or eugonadal (TT ≥300 ng/dL). Pregnancy outcomes were recorded over a 12-month follow-up period.

Significant increases in TT and 17-OHP levels were observed only in hypogonadal men, while TMS and sperm morphology improved in both groups. In hypogonadal men, changes in serum 17-OHP levels (Δ-17-OHP) positively correlated with TMS improvement (r = 0.388, P = .009). Furthermore, in hypogonadal patients, although not statistically significant, Δ-17-OHP were higher in men whose partners achieved pregnancy compared to those whose partners did not.

Varicocele repair improves semen parameters in both hypogonadal and eugonadal men. In hypogonadal men, increases in Δ-17-OHP are linked to TMS improvements, highlighting its potential as a clinical biomarker. Further studies are warranted to validate 17-OHP as a predictor of pregnancy outcomes.