Is Varicocelectomy Useful for Subfertile Men with Isolated Teratozoospermia?
OBJECTIVE
To evaluate the effect of microsurgical varicocelectomy on sperm morphology in subfertile men with isolated teratozoospermia and a clinically palpable varicocele.


METHODS
A retrospective review was performed of men with isolated teratozoospermia who had undergone microsurgical varicocelectomy. Semen analyses following varicocelectomy were performed at 2- to 3-month intervals. Responders to the varicocelectomy were defined as those who fulfilled the following criteria in semen analysis: (1) an improvement in percentage of normal forms to ≥4% and (2) normal results for all other semen parameters.


RESULTS
A total of 80 patients underwent unilateral varicocelectomy (n = 49) or bilateral varicocelectomy (n = 31) (mean age of 36 ± 0.4 years, range 24-44). After a mean postoperative follow-up period of 6.8 months, the mean percentage of normal sperm forms increased from 0.9% to 3.5% (P < .001), and the mean sperm motility improved from 50.5% to 56.6% (P = .004). The number of responders to the surgery was 16 (20%), and their mean percentage of normal forms increased from 1.3% to 9.1%. The mean preoperative and postoperative semen volume and sperm concentration were not different (P > .05). No differences were observed in age, current smoking status, body mass index, or grade of varicocele between responders and nonresponders.


CONCLUSIONS
Varicocelectomy might be an option for treating subfertile patients with isolated teratozoospermia and a clinically apparent varicocele. However, patients should be advised that the surgery helps in limited patients only because more patients did not benefit from the surgery.
Department of Urology, Cheil General Hospital, Dankook University College of Medicine, Seoul, Republic of Korea.
Jin Ho
JH
Choe
Department of Urology, Cheil General Hospital, Dankook University College of Medicine, Seoul, Republic of Korea. Electronic address: jtandro@cgh.co.kr.
Ju Tae
JT
Seo
D000328:Adult; D006801:Humans; D007248:Infertility, Male / Q000150:complications / Q000601:surgery*; D008297:Male; D008866:Microsurgery; D012189:Retrospective Studies; D055101:Semen Analysis; D013081:Sperm Motility; D013094:Spermatozoa / Q000473:pathology*; D014646:Varicocele / Q000601:surgery*; D055815:Young Adult