title: Induction of spermatogenesis in azoospermic men after varicocele repair.
abstract: BACKGROUND
  The purpose of this study was to assess the treatment outcome after varicocele repair in azoospermic men and to correlate this outcome with the testicular histology patterns.
  
  
  METHODS
  Medical records of 15 azoospermic men who underwent testis biopsy and microsurgical repair of clinical varicocele between July 1999 and November 2000 were reviewed. All patients had at least two semen analyses showing azoospermia taken before the surgery and two semen analyses post-operatively. Hypospermatogenesis was identified in four, maturation arrest in six, and germ cell aplasia in five men.
  
  
  RESULTS
  Induction of spermatogenesis was achieved in seven men (47%). Of these, four had germ cell aplasia and three had maturation arrest. The improvement in sperm concentration and motility in patients with germ cell aplasia ranged from 1.8 to 7.9 x 10(6)/ml, and from 32 to 76% respectively. Of these seven patients with improvement in semen quality, five relapsed into azoospermia 6 months after the recovery of spermatogenesis (four germ cell aplasia and one maturation arrest). One patient with maturation arrest established a pregnancy.
  
  
  CONCLUSIONS
  Azoospermic patients may have an improvement in semen quality following varicocelectomy. Semen samples should be cryopreserved after an initial improvement following varicocelectomy, as relapse to a state of azoospermia may occur.
authors.affiliation: Divisão de Clínica Urológica, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Caixa Postal 11 273-9, São Paulo, SP 05422-970, Brasil. conception.rs@uol.com.br
authors.forename: Fábio F
authors.initials: FF
authors.lastname: Pasqualotto
authors.forename: Antônio M
authors.initials: AM
authors.lastname: Lucon
authors.forename: Jorge
authors.initials: J
authors.lastname: Hallak
authors.forename: Plínio M
authors.initials: PM
authors.lastname: Góes
authors.forename: Luiz B
authors.initials: LB
authors.lastname: Saldanha
authors.forename: Sami
authors.initials: S
authors.lastname: Arap
mesh_terms: D000328:Adult; D016922:Cellular Senescence; D005260:Female; D006801:Humans; D008297:Male; D008866:Microsurgery; D009845:Oligospermia / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology*; D011184:Postoperative Period; D011247:Pregnancy; D018873:Pregnancy Rate; D012008:Recurrence; D013076:Sperm Count; D013081:Sperm Motility; D013091:Spermatogenesis; D013094:Spermatozoa / Q000473:pathology / Q000502:physiology; D014646:Varicocele / Q000150:complications* / Q000601:surgery*