[The treatment of varicocele in the infertile male II: results on fertility].
OBJECTIVE
To analyze the efficacy of varicocele treatment, either surgical or endovoscular radiological occlusion, on pregnancy rates of infertile couples in which the male had clinically. patent left varicocele, and to identify which factors are associated with the probability of obtaining pregnancy in such cases.


METHODS
This study is part of a more ample one described in previous article: "The treatment of varicocele in the infertile male I: Results on semen quality". Overall, 183 couples were included. 157 males received treatment (131 radiological occlusion and 26 open surgery), the remaining 26 did not received the treatment indicated. Couples underwent periodic follow-up during the first year, evaluating two parameters: 1) normalization of semen analysis parameters, and 2) pregnancy during the following 12 months after indication of treatment.


RESULTS
Overall, 41 couples (22.4%) achieved pregnancy during first year, 35/157 (22%) in the group of treated patients, and 6/26 (23%) in the non treatment group. In the treatment group, surgical ligature achieved higher pregnancy rates than radiological occlusion (35% vs. 20%), but the difference was not statistically significant (p = 0.255). No association was demonstrated between male age, female age, varicocele clinical grade, degree of semen quality abnormalities, or duration of infertility and pregnancy rates. The FSH value was significantly lower (p 0.0006) in patients who achieved pregnancy.


CONCLUSIONS
The degree of semen quality abnormality, which so closely correlated to normalization of seminal parameters, locked of prognostic significance in terms of achievement of pregnancy. The FSH value was the only factor with certain prognostic value, although it did not reach significance in logistic regression analysis.
Pamplona Casamayor
Manuel
M
Servicio de Urología, Hospital Doce de Octubre, Madrid, España.
Sánchez Guerrero
Angel
A
Bolea Laguarta
M Angeles
MA
de la Cruz Bértolo
Javier
J
Alvarez González
Enrique
E
Duarte Ojeda
José Manuel
JM
González Romojaro
Vicente
V
Tejido Sánchez
Angel
A
Leiva Galvis
Oscar
O
D000328:Adult; D005260:Female; D006801:Humans; D007248:Infertility, Male / Q000150:complications / Q000628:therapy*; D008297:Male; D011247:Pregnancy / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D016896:Treatment Outcome; D014646:Varicocele / Q000150:complications / Q000628:therapy*