Presentation Authors: Filipe Lira Neto*, Ricardo Jose Lisboa Lyra, Jarys Cabral Borges Junior, Recife, Brazil
Introduction: Varicocele is responsible for 35% of primary male infertility cases and found in 80% of men with secondary infertility. Varicocele is also considered the most common correctable cause of male infertility, and microsurgical varicocelectomy (MV) is its gold-standard treatment. Semen parameters improve in up to 80% of infertile men who underwent MV, but there are no clear cut-off values for parameters that can predict a successful outcome after MV. The objective of this study is to compare pre- and intraoperative features of men who improved and did not improve semen parameters after VM.
Methods: We reviewed a database of 85 infertile men submitted to MV by a single surgeon and identified 51 men who were not azoospermic at baseline and that had postoperative semen analysis data. We defined improvement as an increase of more than 10% in the total progressive motile sperm count (TMPS), and we divided the men in two groups: improved (IG) and non-improved (NIG). Preoperative and intraoperative variables were compared between the two groups.
Results: : The IG was composed by 33 (65%) men and the NIG by 18 (35%) men. The IG had a median improvement in the TMPS of 29.0 million/mL and the NIG had a median decrease in the TMPS of 1.2 million/mL. Both groups did not differ regarding mean age, BMI, but the IG had larger testes on physical exam, and larger left vein diameters. There was also a trend to higher varicocele grade on the right side for the IG group. No other intraoperative findings were different between groups. In addition, testosterone, estradiol and follicle stimulating hormone levels were similar in both groups (Table 1).
Conclusions: Men who improved semen parameters after MV seem to have larger varicoceles and larger testicular size where compared with those that did not improve.