Early Period Evaluations after Varicocelectomy: Semen Analysis and Spontaneous Pregnancy Rates
Yıl: 2020 Cilt: 7 Sayı: 3 Sayfa Aralığı: 195 - 199 Metin Dili: İngilizce DOI: 10.4274/jus.galenos.2020.3333 İndeks Tarihi: 10-12-2020
Early Period Evaluations after Varicocelectomy: Semen Analysis and Spontaneous Pregnancy Rates
Öz: Objective: The objective of this study is to evaluate and compare the sperm parameters and spontaneous pregnancy rates of patients with varicoceleand primary infertility at three and six months after surgery.Materials and Methods: We retrospectively evaluated the sperm parameters of 134 male patients who presented with clinical varicocele and primaryinfertility between July 2016 and May 2019. All the patients underwent microscopic inguinal varicocelectomy. We compared the sperm parameters(count, movement, and morphology) and spontaneous pregnancy of the patients preoperatively, and at three and six months postoperatively.Results: In total, 134 patients with a mean age of 26.2 (20-38) years underwent the surgery. We found an increase in all the sperm parameters inthe third and sixth months postoperatively. We also examined the differences among the sperm parameters in the third month and sixth month, andfound a significant increase in the sperm count and motility at six months (p<0.001). The postoperative third-month pregnancy rates were 2.9%(n=4) and 26.8% (n=36) in the sixth month.Conclusion: The improvement in sperm parameters in the third month after varicocele operation continued and increased by the postoperative sixthmonth. Therefore, patients with varicocele and primary infertility should be aware that the rate of spontaneous pregnancy could increase within sixmonths and should wait for at least that period before applying for assistive reproductive techniques.
Anahtar Kelime: Varikoselektomi Sonrası Erken Dönemde Sperm Parametrelerinin ve Spontan Gebelik Oranlarının Değerlendirilmesi
Öz: Amaç: Primer infertilitesi ve klinik varikoseli olan hastalarda varikoselektomi sonrası 3. ve 6. aylarda sperm parametrelerini karşılaştırdık ve spontan gebelik oranlarını değerlendirdik Gereç ve Yöntem: Haziran 2016 - Mayıs 2019 tarihleri arasında üroloji polikliniğine gelen primer infertilitesi ve klinik varikoseli olan toplam 134 hastayı retrospektif olarak değerlendirdik. Tüm hastalara mikroskobik subinguinal varikoselektomi yapıldıktan sonra sperm parametreleri (sayı, hareket, morfoloji) ve spontan gebelik oranları preoperatif dönem ve postoperatif 3. ve 6. aylar değerlendirildi ve karşılaştırıldı. Bulgular: Yüz otuz dört hastaya varikoselektomi yapıldı ve yaş ortalaması 26,2 (20-38) idi. Tüm sperm parametreleri 3. ve 6. ayda yükselmişti. Postoperatif 3. ve 6. ay karşılaştırıldığında sperm sayı ve hızında anlamlı derecede yükselme mevcuttu (p<0,001). Postoperatif 3. ay gebelik oranı %2,9 (n=4) iken postoperatif 6. ayda bu oran %26,8 (n=36) idi. Sonuç: Varikoselektomi sonrası 3. ayda düzelen ve artış gösteren sperm parametreleri 6. ayda da yükselmeye devam etti. Primer enfertilite ile birlikte klinik varikoseli olan hastaların yardımcı üreme tekniklerine başvurmadan önce en azından 6 ay sonra sperm parametrelerindeki yükselmeye bağlı olarak yüksek oranda spontan gebelik ihtimali mevcuttur.
Anahtar Kelime: Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
- 1. Wein AJ, Kavoussi LR, Partin Alan W. Campbell-Walsh, 11th ed. 2016, Elsevier Saunders, 2016.
- 2. Al Bakri A, Lo K, Grober E, Cassidy D, Cordoso JP, Jarvi K. Time for improvement in semen parameters after varicocelectomy. J Urol 2012;187:227-231.
- 3. Thomas A M, Greer AB, Ramasamy R. Time to improvement in semen parameters after microsurgical varicocelectomy in men with severe oligospermia. Can Urol Assoc J 2019;13:66-69.
- 4. World Health Organization, Laboratory Manual for the Examination of Human Semen and Sperm-CervicalMucus Interaction, Cambridge University Press, New York, NY, USA, 4th edition, 1999.
- 5. Enatsu N, Yamaguchi K, Chiba K. Clinical outcome of microsurgical varicocelectomy in infertil men with severe oligospermia. Urology 2014;83:1071-1075.
- 6. Tellaloğlu S, Kadıoğlu TC, Çayan S. Microsurgical high inguinal varicocelectomy and high ligation compared in tratment of varicocele. Br J Urol 1997;80:108.
- 7. Johnsen SG, Agger P. Quantitative evaluation of testicular biopsies before and after operation for varicocele. Fertil Steril 1978;29:58.
- 8. Cockett AT, Harrison RM. Comhaire F, Dublin L. The varicocel and its effect on fertility. Contemp Surg 1984;24:111.
- 9. Saypol DC, Howards SS, Turner TT, Miller ED. Influence of surgically induced varicocele on testicular blood flow,temperature,and histology in adults rats and dogs. Clin Invest 1981;68:39-45.
- 10. Male Infertility Best Practice Policy Committee of the American Urological Association; Practice Committee of the American Society for Reproductive Medicine. Report on varicocele and infertility. Fertil Steril 2004;82(Suppl 1):142-145.
- 11. Practice Committee of American Society for Reproductive Medicine. Report on varicocele and infertility. Fertil Steril 2008;90(Suppl 5):247-249.
- 12. Dohle GR, Colpi GM, Hargreave TB, Papp GK, Jungwirth A, WeidnerW. The EAU Working Group on Male Infertility. EAU guidelines on male infertility. Eur Urol 2005;48:703-711.
- 13. National Collaborating Centre for Women’s and Children’s Health (UK). Fertility: assessment and treatment for people with fertility problems: clinical guideline February 2004.
- 14. Schlesinger MH, Wilets IF, Nagler HM. Treatment outcome after varicocelectomy. A critical analysis. Urol Clin North Am 1994;21:517-529.
- 15. Marmar JL, Kim Y. Subinguinal microsurgical varicocelectomy: a technical critique and statistical analysis of semen and pregnancy data. J Urol 1994;152:1127-1159.
- 16. Madgar I, Weissenberg R, Lunenfeld B, Karasik A,Goldwasser B. Controlled trial of high spermatic vein ligation for varicocele in infertile men. Fertil Steril 1995;63:120-124.
- 17. Marmar JL, Agarwal A, Prabakaran S, Agarwal R, Short RA, Benoff S, Thomas AJ Jr. Reassessing the value of varicocelectomy as a treatment for male subfertility with a new meta-analysis. Fertil Steril 2007;88:639-687.
- 18. Penson DF, Paltiel AD, Krumholz HM, Palter S. The costeffectiveness of treatment for varicocele related infertility. J Urol 2002;168:2490-2494.
- 19. Verza S Jr, Esteves SC. Sperm defect severity rather than sperm source is associated with lower fertilization rates after intracytoplasmic sperm injection. Fertil Steril 2004;82:17.
- 20. Aboulghar MA, Mansour RT, Serour GI, Fahmy I, Kamal A, Tawab NA, Amin YM. Fertilization and pregnancyrates after intracytoplasmic sperm injection using ejaculate semen and surgically retrieved sperm. Fertil Steril 1997;68:108-111.
| APA | Turgut H (2020). Early Period Evaluations after Varicocelectomy: Semen Analysis and Spontaneous Pregnancy Rates. , 195 - 199. 10.4274/jus.galenos.2020.3333 |
| Chicago | Turgut Hasan Early Period Evaluations after Varicocelectomy: Semen Analysis and Spontaneous Pregnancy Rates. (2020): 195 - 199. 10.4274/jus.galenos.2020.3333 |
| MLA | Turgut Hasan Early Period Evaluations after Varicocelectomy: Semen Analysis and Spontaneous Pregnancy Rates. , 2020, ss.195 - 199. 10.4274/jus.galenos.2020.3333 |
| AMA | Turgut H Early Period Evaluations after Varicocelectomy: Semen Analysis and Spontaneous Pregnancy Rates. . 2020; 195 - 199. 10.4274/jus.galenos.2020.3333 |
| Vancouver | Turgut H Early Period Evaluations after Varicocelectomy: Semen Analysis and Spontaneous Pregnancy Rates. . 2020; 195 - 199. 10.4274/jus.galenos.2020.3333 |
| IEEE | Turgut H "Early Period Evaluations after Varicocelectomy: Semen Analysis and Spontaneous Pregnancy Rates." , ss.195 - 199, 2020. 10.4274/jus.galenos.2020.3333 |
| ISNAD | Turgut, Hasan. "Early Period Evaluations after Varicocelectomy: Semen Analysis and Spontaneous Pregnancy Rates". (2020), 195-199. https://doi.org/10.4274/jus.galenos.2020.3333 |
| APA | Turgut H (2020). Early Period Evaluations after Varicocelectomy: Semen Analysis and Spontaneous Pregnancy Rates. Journal of Urological Surgery, 7(3), 195 - 199. 10.4274/jus.galenos.2020.3333 |
| Chicago | Turgut Hasan Early Period Evaluations after Varicocelectomy: Semen Analysis and Spontaneous Pregnancy Rates. Journal of Urological Surgery 7, no.3 (2020): 195 - 199. 10.4274/jus.galenos.2020.3333 |
| MLA | Turgut Hasan Early Period Evaluations after Varicocelectomy: Semen Analysis and Spontaneous Pregnancy Rates. Journal of Urological Surgery, vol.7, no.3, 2020, ss.195 - 199. 10.4274/jus.galenos.2020.3333 |
| AMA | Turgut H Early Period Evaluations after Varicocelectomy: Semen Analysis and Spontaneous Pregnancy Rates. Journal of Urological Surgery. 2020; 7(3): 195 - 199. 10.4274/jus.galenos.2020.3333 |
| Vancouver | Turgut H Early Period Evaluations after Varicocelectomy: Semen Analysis and Spontaneous Pregnancy Rates. Journal of Urological Surgery. 2020; 7(3): 195 - 199. 10.4274/jus.galenos.2020.3333 |
| IEEE | Turgut H "Early Period Evaluations after Varicocelectomy: Semen Analysis and Spontaneous Pregnancy Rates." Journal of Urological Surgery, 7, ss.195 - 199, 2020. 10.4274/jus.galenos.2020.3333 |
| ISNAD | Turgut, Hasan. "Early Period Evaluations after Varicocelectomy: Semen Analysis and Spontaneous Pregnancy Rates". Journal of Urological Surgery 7/3 (2020), 195-199. https://doi.org/10.4274/jus.galenos.2020.3333 |
