Varicocele is found in 8-20% of male population and comprises the most common etiology of male infertiloity. Abnormalities in sperm concentration, motility, and dmorphology are observed on 65 to 75% of varicocele patients. Improvements of such
parameters are seen in 50-80% after surgical correction of varicocele, and fertility is achieved in 30-40% of cases. We evaluated the results of surgical correction of varicocele in both infertile and non-infertile patients. The effects of
varicocele
and subsequent correction on semen parameters and pregnancy were also reviewed.
From September 1987 to December 1995, 254 patients with varicocele were surgically corrected. Semen analysis were performed in 229 patients, revealing abnormalities in 153 (66.8%) patiens, Degree of abnormalities was correlated with the grade of
varicocele and presence of infertility (79.8%)
Improvement of postoperative semen was observed in 112 (73.2%) of 153 patients with abnormal preoperative semen profiles. Improvement was not correlated with grade of varicocele or age, but significnalty correlated with fertility status.
Postoperative
sperm concentration, morphology, and motility were significantly improved in grade II and III varicocele. Sperm motility was improved when correction were perfomed under 30 years of age.
Pregnancy was confirmed in 27 of 88 (30.7%) of infertile patients, and fertility rate was correlated with preoperative sperm concentration and motility, but not correlated with varicocele grade and sperm morphology. Higher pregnancy rate was
observed if
sperm concentration≥40×10E6/ml, normal morphology≥60%, and motility≥60% on the postoperative semen.
In conclusion, varicocele patiens with inefertility are affected by grade, age, and surgical correction. Thus early diasgnosis and treatment should be offered to all patients with varicocele with infertility.
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