title: Clinical significance of subclinical varicocelectomy in male infertility: systematic review and meta-analysis.
abstract: Recent meta-analysis by the Cochrane collaboration concluded that treatment of varicocele may improve an infertile couple's chance of pregnancy. However, there has been no consensus on the management of subclinical varicocele. Therefore, we determine the impact of varicocele treatment on semen parameters and pregnancy rate in men with subclinical varicocele. The randomised controlled trials that assessed the presence and/or treatment of subclinical varicocele were included for systematic review and meta-analysis. Random effect model was used to calculate the weighted mean difference of semen parameters and odds ratio of pregnancy rates. Seven trials with 548 participants, 276 in subclinical varicocelectomy and 272 in no-treatment or clomiphene citrate subjects, were included. Although there was also no statistically significant difference in pregnancy rate (OR 1.29, 95% CI 0.99-1.67), surgical treatment resulted in statistically significant improvements on forward progressive sperm motility (MD 3.94, 95% CI 1.24-6.65). However, the evidence is not enough to allow final conclusions because the quality of included studies is very low and further research is needed.
authors.affiliation: Institute for Evidence-based Medicine, College of Medicine, Korea University, Seoul, Korea.
authors.forename: H J
authors.initials: HJ
authors.lastname: Kim
authors.affiliation: Department of Urology, Cheil General Hospital, Dankook University College of Medicine, Seoul, Korea.
authors.forename: J T
authors.initials: JT
authors.lastname: Seo
authors.affiliation: Department of Urology, Yonsei University Wonju College of Medicine, Wonju, Korea.
authors.forename: K J
authors.initials: KJ
authors.lastname: Kim
authors.affiliation: Institute for Evidence-based Medicine, College of Medicine, Korea University, Seoul, Korea.
authors.forename: H
authors.initials: H
authors.lastname: Ahn
authors.affiliation: Center for Health Promotion, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: J Y
authors.initials: JY
authors.lastname: Jeong
authors.affiliation: Department of Urology, Mizmedi Hospital, Seoul, Korea.
authors.forename: J H
authors.initials: JH
authors.lastname: Kim
authors.affiliation: Department of Urology, CHA Gangnam Medical Center, CHA University, Seoul, Korea.
authors.forename: S H
authors.initials: SH
authors.lastname: Song
authors.affiliation: Department of Urology, Yonsei University Wonju College of Medicine, Wonju, Korea.
authors.forename: J H
authors.initials: JH
authors.lastname: Jung
mesh_terms: D005260:Female; D006801:Humans; D007248:Infertility, Male / Q000209:etiology / Q000601:surgery*; D008297:Male; D011247:Pregnancy; D018873:Pregnancy Rate; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014646:Varicocele / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D014656:Vascular Surgical Procedures
keywords: Infertility; male; pregnancy outcome; semen analysis; varicocele