title: Assessment of Time-dependent Changes in Semen Parameters in Infertile Men After Microsurgical Varicocelectomy.
abstract: OBJECTIVE
  To characterize the changes in seminogram findings in infertile men after varicocelectomy.
  
  
  METHODS
  This study included 71 consecutive infertile men who underwent microsurgical low ligation varicocelectomy and received 3 semen analyses, 1 before microsurgical varicocelectomy and again at 3 and 12 months after. Total motile sperm count (TMSC) was calculated using the following formula: [volume (mL) × concentration (millions/mL) × motility (%)].
  
  
  RESULTS
  Despite the lack of significant changes in the proportion of sperm with abnormal morphology, sperm concentration, motility, and TMSC in the 71 patients were significantly higher at 3 and 12 months after varicocelectomy than before surgery. However, no further improvement in these parameters at 12 months after varicocelectomy was noted compared with those at 3 months. Furthermore, when the included men were divided into 3 groups according to preoperative TMSC as <3 million, 3-9 million, and >9 million, TMSCs at 3 months after varicocelectomy in all 3 groups were significantly higher than those before varicocelectomy; however, TMSCs at 12 months after surgery in all groups were similar to those at 3 months.
  
  
  CONCLUSIONS
  The level of improvement in semen parameters at 3 months after varicocelectomy may be stable at 12 months after surgery, irrespective of baseline values of TMSC. Therefore, varicocelectomy could be offered as a therapeutic option for infertile men, even for couples with an older woman, because its efficacy is evaluable at 3 months after surgery, and assisted reproductive technology could be immediately applied to ineffective cases.
authors.affiliation: Division of Urology, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Teruo
authors.initials: T
authors.lastname: Fukuda
authors.affiliation: Division of Urology, Kobe University Graduate School of Medicine, Kobe, Japan. Electronic address: hideakimiyake@hotmail.com.
authors.forename: Hideaki
authors.initials: H
authors.lastname: Miyake
authors.affiliation: Division of Urology, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Noritoshi
authors.initials: N
authors.lastname: Enatsu
authors.affiliation: Division of Urology, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Kei
authors.initials: K
authors.lastname: Matsushita
authors.affiliation: Division of Urology, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Masato
authors.initials: M
authors.lastname: Fujisawa
mesh_terms: D000328:Adult; D006801:Humans; D007248:Infertility, Male / Q000175:diagnosis / Q000209:etiology / Q000378:metabolism*; D008026:Ligation; D008297:Male; D008866:Microsurgery / Q000379:methods*; D008875:Middle Aged; D011183:Postoperative Complications; D011446:Prospective Studies; D055101:Semen Analysis; D013081:Sperm Motility; D013997:Time Factors; D018608:Ultrasonography, Doppler; D013521:Urologic Surgical Procedures, Male / Q000379:methods*; D014646:Varicocele / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D055815:Young Adult