Factors affecting fertility after varicocelectomy

Area of Science:

• Urology
• Andrology
• Reproductive Medicine

Background:

• Varicocele, a common cause of male infertility, often leads to disturbed spermatogenesis.
• High ligation of the internal spermatic vein is a surgical option for varicocele treatment.

Purpose of the Study:

• To evaluate the postoperative fertility outcomes after high ligation of the internal spermatic vein in men with left varicocele.
• To identify predictors of successful fertility improvement post-surgery.

Main Methods:

• 27 patients with left varicocele and spermatogenesis disturbance underwent high ligation of the internal spermatic vein.
• Postoperative fertility was assessed, categorizing patients into groups based on pregnancy, improved sperm count, or no improvement.
• Preoperative and postoperative clinical and hormonal parameters were analyzed.

Main Results:

• Patients were grouped into: I (pregnancy), II (improved sperm count, no pregnancy), and III (no improvement).
• Key indicators for predicting postoperative fertility included bilateral testicular volume, testicular histology, serum Follicle-Stimulating Hormone (FSH), and response to Luteinizing Hormone-Releasing Hormone (LH-RH) administration.

Conclusions:

• High ligation of the internal spermatic vein can lead to successful fertility outcomes in select patients with varicocele.
• Testicular volume, histology, FSH levels, and LH-RH response are valuable markers for assessing the potential for fertility recovery after varicocele surgery.