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Abstract

Volume 24, Issue 1 (January 2022) 24, 85–89; 10.4103/aja.aja_29_21

Effect of varicocele repair on sperm retrieval rate and testicular histopathological patterns in men with nonobstructive azoospermia

Ponco Birowo1,2, Dimas Tri Prasetyo1, Dwi Ari Pujianto3, Widi Atmoko1, Nur Rasyid1, Ivan Rizal Sini2

1 Department of Urology, Faculty of Medicine, Universitas Indonesia - Dr. Cipto Mangunkusumo Hospital, Jakarta 10430, Indonesia
2 Indonesian Reproductive Science Institute, Bunda General Hospital, Jakarta 10310, Indonesia
3 Department of Medical Biology, Faculty of Medicine, Universitas Indonesia, Jakarta 10430, Indonesia

Correspondence: Dr. P Birowo (ponco.birowo@gmail.com)

Date of Submission 19-Aug-2020 Date of Acceptance 21-Mar-2021 Date of Web Publication 18-May-2021

Abstract

Varicocele adversely affects semen parameters. However, the effect of varicocele repair on the sperm retrieval rate and testicular histopathological patterns in men with nonobstructive azoospermia has not been widely reported. We retrospectively assessed the sperm retrieval rates and testicular histopathological patterns in men with nonobstructive azoospermia who were referred to the Urology Clinic in Dr. Cipto Mangunkusumo Hospital (Jakarta, Indonesia) and Bunda General Hospital (Jakarta, Indonesia) between January 2009 and December 2019. We compared patients who had undergone a surgical sperm retrieval procedure for assisted reproductive technology no earlier than three months after varicocele repair and those who had not undergone varicocele repair. The study included 104 patients (age range: 26–54 years), 42 of whom had undergone varicocele repair before the sperm retrieval procedure and 62 who had not. Motile spermatozoa were found in 29 (69.1%) and 17 (27.4%) patients who had undergone varicocele repair before the sperm retrieval procedure and those who had not undergone the repair, respectively (relative risk: 2.51; 95% confidence interval: 1.60–3.96; P < 0.001). A predicted probabilities graph showed consistently higher sperm retrieval rates for patients with varicocele repair, regardless of their follicle-stimulating hormone levels. Patients who underwent varicocele repair showed higher testicular histopathological patterns (P = 0.001). In conclusion, men with nonobstructive azoospermia and clinical varicocele who underwent varicocele repair before the sperm retrieval procedure had higher sperm retrieval rates compared to those who did not undergo varicocele repair.

Keywords: azoospermia; follicle-stimulating hormone; sperm retrieval rate; testicular histopathology; varicocele

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