Samplaski MK, et al. - The study performed to ascertain the magnitude of improvement in semen parameters after a varicocelectomy and the fraction that have improvements such that couples needing in vitro fertilization (IVF) or intrauterine insemination (IUI) are “upgraded” to needing less invasive assisted reproductive technology (ART). Varicocele repair has an important role in the treatment of infertility. Even for low total motile sperm counts (TMSCs), a varicocelectomy may decrease the requirement for IVF. Varicocele repair (by embolization or microsurgery) potentially decreases the requirement for IVF and IUI. To decide the size of the change in semen parameters after a varicocelectomy and the division that have enhancements with the end goal that couples requiring IVF or IUI are "updated" to requiring less intrusive helped conceptive innovation (ART). Varicocele repair has an essential part in the treatment of fruitlessness. Notwithstanding for low TMSCs, a varicocelectomy may diminish the requirement for IVF. Varicocele repair (by embolization or microsurgery) possibly decreases the requirement for IVF and IUI.

Methods

• For this study, they designed a retrospective review of prospectively collected data.
• This study was conducted at academic medical centers.
• Men presenting for a fertility evaluation with a clinical varicocele were enrolled in this study.
• Total motile sperm count (TMSC) before and after repair, and the proportion of men considered candidates for: natural pregnancy (NP) >9 million, IUI 5-9 million, or IVF < 5 million.

Results

• They found a total of 373 men underwent varicocele repair.
• In this study, the TMSC increased from 18.22 ± 38.32 to 46.72 ± 210.92 (P=.007).
• The most pronounced increase was with baseline TMSC <5 million, from 2.32 ± 1.50 to 15.97 ± 32.92 (P=.0000002); 58.8% of men were upgraded from IVF candidacy to IUI or NP.
• For baseline TMSC 5–9 million, the mean TMSC increased from 6.96 ± 1.16 to 24.29 ± 37.17 (P=.0004), allowing 64.9% of men to become candidates for NP.
• For baseline TMSC of >9 million, TMSC increased from 36.26 ± 52.08 to 81.80 ± 310.83 (P=.05).