The Effects of Varicocelectomy on Sperm DNA Fragmentation and Conventional Semen Parameters in Men with Severe Oligoasthenoteratozoospermia: A Prospective Study
نویسندگان
1 Urology Service, University Hospital Center, Mohammed VI Oujda, Morocco
2 Maternal-Child and Mental Health Research Laboratory, Faculty of Medicine and Pharmacy, First Mohammed University, Oujda, Morocco
3 Medically Assisted Procreation Unit, Central Laboratory, Mohammed VI University Hospital Center, Oujda, Morocco
4 Maternal-Child and Mental Health Research Laboratory, Faculty of Medicine and Pharmacy, First Mohammed University, Oujda, Morocco
5 Maternal-Child and Mental Health Research Laboratory, Faculty of Medicine and Pharmacy, First Mohammed University, Oujda, Morocco
6 Medically Assisted Procreation Unit, Central Laboratory, Mohammed VI University Hospital Center, Oujda, Morocco
7 Medically Assisted Procreation Unit, Central Laboratory, Mohammed VI University Hospital Center, Oujda, Morocco
8 Obstetrics Gynecology Service, Mohammed VI University Hospital Center, Oujda, Morocco
9 Medically Assisted Procreation Unit, Central Laboratory, Mohammed VI University Hospital Center, Oujda, Morocco
doi
10.22074/ijfs.2023.2002260.1465چکیده
Background: The dilation and torsion of testicular veins in the plexus pampiniformis causes Varicocele, which is asurgically repairable cause of male infertility. This study assessed the impact of varicocelectomy on semen characteristics,total motile sperm count (TMSC) and sperm DNA integrity in patients with severe oligoasthenoteratozoospermia(OAT).Materials and Methods: In this prospective study, semen samples of 360 men with severe OAT who underwentvaricocelectomy according to World Health Organization (WHO) criteria 2021 were studied (pre-operatively and at 6,12, and 18 months post-operatively).Results: The average age of our patients was 38.5 years. The mean spermatozoa concentration was found to be 1.60 ±0.83 million/ml pre-operatively, while the mean post-operative concentration was 5.17 ± 1.23 million/ml at 6 months,8.32 ± 0.98 million/ml at 12 months, and 13.51 ± 1.48 million/ml at 18 months (P<0.0001). The mean percentageof A+B motile spermatozoa was 2.92 ± 1.17% pre-operatively, 6.10 ± 1.51% at six months, 9.58 ± 1.49% at 12months and 13.92 ± 1.88% at 18 months postoperatively (P<0.0001). The mean Modified David’s morphology scorewas 3.80 ± 1.43% pre-operatively, 5.95 ± 1.23% at 6 months, 7.94 ± 1.18% at 12 months, and 10.82 ± 1.91% at 18months post-operatively (P<0.0001). The mean of total motile sperm count (TMSC) was statistically improved aftervaricocelectomy (P<0.001). The mean of DNA fragmentation index (DFI) of the spermatozoa was 31.40 ± 0.52%pre-operatively, and post-operatively at 28.20 ± 0.32% at 6 months, 25.90 ± 0.31% at 12 months and 20.50 ± 0.40%at 18 months (P<0.001).Conclusion: Varicocelectomy was associated with significant improvement of sperm parameters and DNA fragmentationresulting in significant improvement of spermatogenesis quality. We believe that universalization in the routinelyused sperm dispersion chromatin (SDC) test could be beneficial in the treatment of infertility.
