Effect of performing varicocelectomy before intracytoplasmic sperm injection on clinical outcomes in non-azoospermic males

Objective To compare laboratory outcomes and pregnancy rates of infertile couples, in which male partners have treated and untreated clinical varicocele before performing ICSI. Materials and methods The data of 306 couples in whom ICSI was performed due to infertility were evaluated retrospectively....

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Bibliographic Details
Published in:International urology and nephrology 2013-04, Vol.45 (2), p.367-372
Main Authors: Gokce, Mehmet Ilker, Gülpınar, Ömer, Süer, Evren, Mermerkaya, Murat, Aydos, Kaan, Yaman, Önder
Format: Article
Language:English
Subjects:
Adult
Azoospermia - etiology
Clinical outcomes
Female
Humans
Male
Medicine
Medicine & Public Health
Nephrology
Pregnancy - statistics & numerical data
Retrospective Studies
Sperm Injections, Intracytoplasmic
Urology
Urology - Original Paper
Varicocele - complications
Varicocele - surgery
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Summary:Objective To compare laboratory outcomes and pregnancy rates of infertile couples, in which male partners have treated and untreated clinical varicocele before performing ICSI. Materials and methods The data of 306 couples in whom ICSI was performed due to infertility were evaluated retrospectively. All of the males had clinical varicocele, and patients were evaluated in two groups. Group A ( n  = 168) included patients who underwent successful varicocele repair and Group B ( n  = 138) included patients with clinical varicocele at the time of ICSI and no history of varicocele repair. Semen analysis, demographic factors and live birth and pregnancy rates were recorded. Results There were 168 patients (54.9 %) in group A and 138 patients (45.1 %) group B. Groups were similar for demographic factors. Semen analysis results were significantly better after varicocelectomy. Pregnancy rates were higher in group A (62.5 vs. 47.1 %, p  = 0.001). Live birth rates were also higher in group A (47.6 vs. 29.0 %, p  = 0.0002). In the logistic regression analysis, varicocelectomy was found to increase the rates of viable pregnancy (OR 2.02, 95 % CI 1.25–3.87; p  = 0.032), live births (OR 2.12, 95 % CI 1.26–3.97; p  = 0.026). Conclusion Performing varicocelectomy improves the pregnancy and live birth rates by ICSI in infertile couples in whom the male partner has clinical varicocele. Varicocelectomy should be offered before ICSI to infertile men with clinical varicocele. However, further prospective randomized studies are needed to confirm benefit of varicocelectomy before ICSI.
ISSN:0301-1623
1573-2584
DOI:10.1007/s11255-013-0394-2