Fertility Outcomes After Varicocele Repair: Are There Any Benefits? A Traditional Review

Author(s): Iana Malasevskaia, Ahmed Ali Al-Awadhi, Fatima Ali Raza

Backgrounds: A varicocele is identified in 15% of healthy men and around 40% of men with primary infertility suffer from some degree of varicocele. The presence of spermatic varicose veins creates a hostile environment for spermatogenesis. It results in reduced quality and quantity of sperm production and, in some cases, can conduce to a total absence of sperm. This is due to an increase in circulating reactive oxygen species (ROS) resulting in sperm DNA fragmentation, even if the conventional semen parameters are within the normal reference ranges. It has been proposed that treating the varicocele may result in improvements in the semen parameters, fertilization, and pregnancy rates. Additionally, treating the varicocele could improve the results of both spontaneous pregnancies as well as following in vitro fertilization (IVF), intracytoplasmic sperm injection (ICSI), and Assisted Reproduction Treatment (ART) in the presence of suboptimal semen parameters.

Aim: We are performing a review of the literature with the aim to evaluate the evidence of the indications and advantages of treatment of varicocele in infertile men. And additionally, we are analyzing the results achieved after the varicocele repair.

Methods: A literature search in PMC, PubMed, Google, and Google Scholar was carried out using the following keywords: ”varicocele”, “varicocelectomy”, “male infertility”, “varicocelectomy and fertility outcome”. Study selection was in the language (English only), model (humans only), open accesses, and all types of studies were included as long as they were relevant to our study.

Limitations: While we were gathering the information for this review, there were some limitations. Our data was primarily obtained from articles with free full access and written in English language only; thus, relevant articles of closed access and written in other languages may have been skipped. This review article is a traditional review and, therefore, does not follow the Standard Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for systematic reviews.

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