Improvement in Semen Parameters and Fertility Rate After Varicocelectomy

Muhammad Mansoor, Ahmed Nawaz, Saeed Ahmed Khan

Abstract

Objective

To determine the mean change of semen parameters and fertility rate after surgery for Varicocele

Study design

Cross sectional study.

Place & Duration of study•

Department of Urology, Jinnah Postgraduate Medical Center (JPMC) Karachi, from January 2015 to December 2019.

Methodology

Patients with primary infertility with oligo-asthenospermia, and clinically demonstrable varicocele (Grade II and III) were included in the study. Detailed history and examination were done. Doppler color ultrasound was used to assess the diameter of varicocele based upon diameter of vessels > 2.4mm and reversal of venous flow. Pre and post- varicocelectomy semen analysis were done. Sixth month sample report was taken as reference. Pre and post- operative semen parameters were compared and tabulated. Postoperative fertility rate and complications were also recorded.

Results

Total of 95 patients were included in this study. Age was from 18 year to 45 year with mean age of 32.63+ 7.97 year. Fifty-five patients (58%) belonged to age more than 30 years. Unilateral left sided primary varicocele was noted in 84.2% of patients. Grade II varicocele was noted in 69.4% of patients while grade III in 30.6%. Both open inguinal and laparoscopic methods were used for vaicocelectomy. After surgery, sperm concentration, motility and morphology of semen were significantly increased (p<0.001) but little change found in the volume of semen. There was no significant difference in improvement in semen parameters in patients below and above 30 years of age (p= 0.24). Postoperative fertility rate was 14.7%, with recurrence rate of 4.2%.

Conclusion

Varicocelectomy significantly improved the semen parameters and chances of fertility.

Key words

Primary infertility, Varicocelectomy, Semen parameters.