Infertility Period Linked to Pregnancy Rate in Varicocele

Longer period before varicocelectomy linked to lower rate, lower total motile sperm counts

MONDAY, April 20 (HealthDay News) -- Following varicocelectomy, men with longer periods of infertility achieve lower pregnancy rates, indicating a harmful effect from the varicocele on the testicles over time, according to research published in the April issue of Urology.

Unal O. Zorba, M.D., of Istanbul University in Turkey, and colleagues analyzed data from 574 men with varicocele. The researchers classified the men in four groups based on their infertility period, defined as duration of unprotected intercourse without conception: zero to three years, three to six years, six to nine years, and greater than nine years. All men underwent microscopic varicocelectomies.

Afterward, 41.3 percent of couples had spontaneous pregnancy. The highest pregnancy rate was in the group with the shortest infertility period, and the lowest was in the group with the longest period, the researchers noted. These groups had mean postoperative total motile sperm counts of 34.9 x 106 and 24.6 x 106, respectively

"Current noninvasive modalities, such as semen analysis and measurement of testicular size and serum gonadotropins, should be used to identify early changes in testicular physiology caused by a varicocele. The goal of varicocele management is to improve testicular function and the seminal parameters and to increase the likelihood of the ultimate goal (i.e., an increased pregnancy rate)," the authors conclude. "If considering expectant management for patients with varicocele, one should take the duration of the infertility period into account."

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