title: Impact of a second semen analysis on a treatment decision making in the infertile man with varicocele.
abstract: OBJECTIVE
  To evaluate the impact of second semen analysis (SA) on a treatment decision in infertile men with varicocele and abnormal first SA.
  
  
  METHODS
  Retrospective chart review.
  
  
  METHODS
  University hospital.
  
  
  METHODS
  None.
  
  
  METHODS
  Standard clinical semen analysis.
  
  
  METHODS
  A total of 160 infertile men with varicocele and abnormal first SA were evaluated. Two SA were performed in the same andrology lab 3 to 8 weeks apart. Exclusion criteria were azoospermia, low semen volume, leukocytospermia, febrile illness within 3 months, and habitual heat exposure.
  
  
  RESULTS
  Despite fluctuation in absolute values of sperm concentration, motility, and morphology, the second SA remained abnormal in 111 out of 112 men (99.1%) with abnormal first SA.
  
  
  CONCLUSIONS
  Initial abnormal SA is a sufficient indication for varicocele treatment because in most patients the second SA remains abnormal and does not change treatment decision. This approach will expedite treatment of infertile men with varicocele and increase its cost effectiveness.
authors.affiliation: Department of Urology, State University of New York at Stony Brook, Stony Brook, New York 11794-8093, USA.
authors.forename: Alek
authors.initials: A
authors.lastname: Mishail
authors.forename: Susan
authors.initials: S
authors.lastname: Marshall
authors.forename: David
authors.initials: D
authors.lastname: Schulsinger
authors.forename: Yefim
authors.initials: Y
authors.lastname: Sheynkin
mesh_terms: D003657:Decision Making; D006801:Humans; D007248:Infertility, Male / Q000628:therapy*; D008297:Male; D012189:Retrospective Studies; D055101:Semen Analysis; D014646:Varicocele / Q000628:therapy*