Authors:
Matkov TG. Zenni M. Sandlow J. Levine LA.
Institution:
Dr. L. A. Levine, Department of Urology, Rush-Presbyterian-St. Lukes Med Ctr, 1725 West Harrison, Chicago, IL 60612; United States.
Title:
Preoperative semen analysis as a predictor of seminal improvement following varicocelectomy (2001-3257).
Source:
Fertility and Sterility. Vol 75(1) (pp3-68), 2001.
Abstract:
Objectives:
To determine the predictive role of preoperative semen analysis on both seminal improvement and pregnancy rates following varicocelectomy.
Design:
Retrospective data analysis.
Setting:
Two academic medical "center" infertility clinics.
Patients:
One hundred ten consecutive patients who underwent varicocelectomies. Seminal improvement data were available for 84 patients, and pregnancy data were available for 58 patients.
Interventions:
Stratification of patients based on preoperative total motile sperm count (TM). Varicocelectomy was performed on all patients.
Main Outcome Measure(s):
TMs, pregnancy rates, and conception techniques following varicocelectomy of each preoperative group.
Results:
Men with mild to moderate oligoasthenospermia (TM<5 million) had significantly better seminal improvement following varicocelectomy. While preoperative stratification showed no difference in pregnancy rates (when assisted reproductive techniques were included), men who achieved a postoperative TM >20 million were more likely to achieve conception by less invasive techniques (natural and intrauterine insemination vs. in vitro fertilization [IVF]).
Conclusion(s):
Varicocelectomy may be the most cost-effective initial intervention in males with TM >5 million. Patients with TM<5 million and concomitant female factor infertility may be better initial candidates for IVF.
   
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