title: Induction of spermatogenesis and achievement of pregnancy after microsurgical varicocelectomy in men with azoospermia and severe oligoasthenospermia.
abstract: OBJECTIVE
  To characterize treatment outcome after varicocele repair in men with azoospermia and severe oligoasthenospermia.
  
  
  METHODS
  Prospective nonrandomized study.
  
  
  METHODS
  University-based medical center.
  
  
  METHODS
  Seventy-eight men with a palpable varicocele and absolute azoospermia (n = 22) or severe oligoasthenospermia (n = 56).
  
  
  METHODS
  Microsurgical varicocelectomy.
  
  
  METHODS
  Sperm count and pregnancy rate.
  
  
  RESULTS
  Twelve (55%) of the 22 men with azoospermia and 35 (69%) of the 51 men with zero motile sperm before surgery had motile sperm observed in their ejaculate after varicocele repair. The total number of motile sperm per ejaculate increased from 0.08 +/- 0.02 x 10(6) before varicocelectomy to 7.2 +/- 2.3 x 10(6) afterward. Twenty-four men (31%) contributed to pregnancies leading to live births (15 unassisted [19%]), including 3 men with azoospermia preoperatively.
  
  
  CONCLUSIONS
  Varicocele repair resulted in the induction or enhancement of spermatogenesis for most men with azoospermia or severe oligoasthenospermia. Unassisted pregnancies after varicocele repair in men with profound abnormalities of spermatogenesis are possible. Varicocele repair should be considered for all men with azoospermia and severe oligoasthenospermia.
authors.affiliation: Center for Male Reproductive Medicine and Microsurgery, Department of Urology, The New York Hospital-Cornell Medical Center, New York 10021, USA.
authors.forename: G J
authors.initials: GJ
authors.lastname: Matthews
authors.forename: E D
authors.initials: ED
authors.lastname: Matthews
authors.forename: M
authors.initials: M
authors.lastname: Goldstein
mesh_terms: D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D006801:Humans; D008297:Male; D008866:Microsurgery; D009845:Oligospermia / Q000209:etiology*; D011247:Pregnancy; D013076:Sperm Count; D013081:Sperm Motility / Q000502:physiology; D013091:Spermatogenesis / Q000502:physiology*; D013737:Testis / Q000503:physiopathology; D014646:Varicocele / Q000150:complications / Q000503:physiopathology / Q000601:surgery*
chemical_list: D005640:Follicle Stimulating Hormone