CJK 11. China experience of microsurgical subinguinal varicocelectomy for infertile men

The study investigated the effect of microsurgical subinguinal varicocelectomy in male infertility.

A prospective study was conducted at the Andorlogy center of Peking University First Hospital from January 2009 to February 2011. Married men 20-46 year of age who had experience infertility ≥1 year, had palpable varicoceles, and with at least one impaired semen parameter (sperm concentration <20 million/ ml, progressive motility <50%, or normal morphology <30%) were eligible. Exclusions included subclinical or recurrent varicoceles, normal semen parameters, and azoospermia. All the patients were performed with subinguinal microsurgical varicocelectomy. Semen analyses were obtained at baseline (three analyses) and at follow-up months 3, 6, 9, and 12. The mean of each sperm parameter at baseline and follow-ups was determined. Testosterone and inhibin were measured before and 12 months after the operation. We measured the spontaneous pregnancy rate, changes from baseline in mean semen parameters, changes from baseline in testosterone and inhibin, and the occurrence of adverse events during 12-months followup. Paired t-test was used to test the differences pre- and postthe operation, when P<0.05 was considered significant.

127 patients were enrolled into the study and the mean age was 28.6±7.3 years. Spontaneous pregnancy was achieved in 40.16%. The mean of all semen parameters, testosterone and inhibin improved significantly in follow-up versus baseline (P<0.05). No adverse events were reported after the operation 12 months later.

Our result provided the effect of varicocelectomy over observation in infertile men with palpable varicoceles and impaired semen quality, with increased spontaneous pregnancy rate and improvements in semen characteristics, testosterone and inhibin within 12 months of follow-up.