title: Differences in the clinical characteristics of primarily and secondarily infertile men with varicocele.
abstract: OBJECTIVE
  To compare the clinical characteristics of primarily and secondarily infertile men with varicocele.
  
  
  METHODS
  Cross-sectional analysis.
  
  
  METHODS
  Male infertility clinic, tertiary health care center.
  
  
  METHODS
  Two hundred ninety-five infertile men with palpable varicoceles.
  
  
  METHODS
  Clinical evaluation including patient reproductive history (including assessment of primary or secondary infertility), physical examination, hormonal assessment and at least two semen analyses.
  
  
  METHODS
  Differences in the characteristics of men with primary vs. secondary infertility.
  
  
  RESULTS
  Two hundred five subjects were identified with primary infertility and 90 with secondary infertility. Secondarily infertile men were older (39.6 years vs. 35.0 years), with older partners (35.4 years vs. 33.2 years), but had higher sperm densities (51.3 vs. 36.0 million/mL) and a greater percentage of morphologically normal sperm (30.6% vs. 24.1%). A lower proportion of secondarily infertile men had total motile sperm count (TMC) <20 million compared with primarily infertile men (31.1% vs. 46.5%). Groups did not differ regarding infertility duration, tobacco or alcohol use, varicocele grade or laterality, testis volumes, or hormonal parameters. In multivariate modeling, secondary infertility (vs. primary) was an independent predictor of TMC >20 million (odds ratio 1.9).
  
  
  CONCLUSIONS
  Men with secondary infertility are older and have older partners than primarily infertile men, yet they have significantly better sperm concentrations. Infertility in this group may be influenced by maternal reproductive potential.
authors.affiliation: Department of Urology, University of California, San Francisco, California 94143-1695, USA. twalsh@urology.ucsf.edu
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Walsh
authors.forename: Alex K
authors.initials: AK
authors.lastname: Wu
authors.forename: Mary S
authors.initials: MS
authors.lastname: Croughan
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Turek
mesh_terms: D000328:Adult; D000367:Age Factors; D048430:Cell Shape; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007248:Infertility, Male / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology; D016015:Logistic Models; D008297:Male; D016017:Odds Ratio; D018570:Risk Assessment; D012307:Risk Factors; D013076:Sperm Count; D013081:Sperm Motility; D013091:Spermatogenesis; D013094:Spermatozoa / Q000473:pathology*; D014646:Varicocele / Q000150:complications* / Q000473:pathology / Q000503:physiopathology