title: Does the duration of infertility affect semen parameters and pregnancy rate after varicocelectomy? A retrospective study.
abstract: OBJECTIVE
  The most common indication for treatment of varicocele is still male subfertility. The aim of this study was to explore the effect of infertility duration on semen parameters and spontaneous pregnancy rate after varicocelectomy.
  
  
  METHODS
  The medical records of 183 infertile patients with clinical varicocele were retrospectively reviewed. The patients were divided into three groups according to the duration of infertility (group I, 1-3 years, group II, 3-6 years and group III, > 6 years). Total sperm motility counts (TMCs) before and after varicocelectomy and spontaneous pregnancy rate among these groups were statistically compared.
  
  
  RESULTS
  The greatest changes, regarding preoperative and postoperative TMCs and spontaneous pregnancy rate were noticed between group I and III. Preoperative TMCs in group I and III was 15.2 ± 1.2, 7.8 ± 1.4, respectively (p < 0.05). Postoperative TMCs in group I and III was 33.7 ± 2.5, 25.2 ± 1.9, respectively (p < 0.05). An overall spontaneous pregnancy rate of 34.4% was achieved after inguinal varicocelectomy. The greatest spontaneous pregnancy rate was achieved in Group I (37.3%), and the lowest pregnancy rate in Group III (26.3%) (P < 0.05).
  
  
  CONCLUSIONS
  Surgical varicocelectomy improves the total sperm motility counts especially in patients who have a TMCS more than 5 million and improves the spontaneous pregnancy rates. The improvement in the spontaneous pregnancy rates after varicocelectomy correlates negatively with the duration of infertility. Therefore, duration of infertility should be considered in treating a patient with a varicocele as a cause of infertility.
authors.affiliation: King Abdullah university Hospital, Faculty of Medicine, Jordan University of Science and technology, Irbid, Jordan. alghazo@just.edu.jo
authors.forename: Mohammed A
authors.initials: MA
authors.lastname: Al-Ghazo
authors.forename: Ibrahim Fathi
authors.initials: IF
authors.lastname: Ghalayini
authors.forename: Rami S
authors.initials: RS
authors.lastname: al-Azab
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Bani-Hani
authors.forename: Mohammad S
authors.initials: MS
authors.lastname: Daradkeh
mesh_terms: D000328:Adult; D053713:Azoospermia / Q000150:complications; D005260:Female; D006801:Humans; D007248:Infertility, Male / Q000209:etiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011184:Postoperative Period; D011247:Pregnancy; D018873:Pregnancy Rate; D057234:Preoperative Period; D012189:Retrospective Studies; D055101:Semen Analysis; D013076:Sperm Count; D013081:Sperm Motility; D013997:Time Factors; D014646:Varicocele / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D055815:Young Adult