Semen Parameter Response to Varicocele Repair in Infertile Men With Cryptozoospermia.

Abstract

To assess varicocele repair effect on semen parameters and improved candidacy for in vitro fertilization/intracytoplasmic sperm injection or lesser involved treatment options depending on semen parameter response following varicocele repair in infertile men presenting with baseline semen analyses revealing cryptozoospermia. A retrospective chart review of the electronic health records was performed in men presenting for fertility evaluation with a palpable varicocele on physical examination and at least 2 consecutive semen analyses revealing cryptozoospermia who underwent subinguinal microsurgical varicocele repair. Of the 24 men with cryptozoospermia who underwent varicocele repair, 54% had improvement in semen parameters from cryptozoospermia preoperatively to semen parameters ranging from severely oligozoospermic to normozoospermic 3 to 6 months postoperatively. Statistical analyses did not demonstrate significant associations between patient age, follicle-stimulating hormone level, or clinical grade of varicocele and semen parameter response following varicocele repair. Greater than half of the men with cryptozoospermia that underwent varicocele repair improved semen parameters to be optimized for in vitro fertilization/intracytoplasmic sperm injection or potentially lesser involved fertility treatments and obviated the need for surgical sperm retrieval. Neither patient age, serum follicle-stimulating hormone level, nor clinical grade of varicocele showed a statistically significant association with favorable vs unfavorable semen parameter response to varicocele repair in infertile men with preoperative cryptozoospermia. These data suggest that varicocele repair may be offered to infertile, cryptozoospermic men with palpable varicoceles.