Document Type : Original Article
Authors
1
Maternal-Child and Mental Health Research Laboratory, Faculty of Medicine and Pharmacy, Mohammed First University, Oujda, Morocco
2
Obstetrics Gynecology Service, Mohammed VI University Hospital center, Oujda, Morocco
3
Urology Service, University Hospital center, Mohammed VI Oujda, Morocco
4
Maternal-Child and Mental Health Research Laboratory, Faculty of Medicine and Pharmacy, First Mohammed University, Oujda, Morocco
5
Medically assisted procreation unit, Central Laboratory, Mohammed VI University Hospital center, Oujda, Morocco
10.22074/ijfs.2023.2002260.1465
Abstract
Introduction: The dilation and torsion of testicular veins in the plexus pampiniformis causes Varicocele, which is a surgically repairable cause of male infertility. This study assessed the impact of varicocelectomy on semen characteristics, total motile sperm count (TMSC) and sperm DNA integrity in patients with severe oligoasthenoteratozoospermia (OAT).
Patients and Methods: In this study, we examined semen samples of 360 men with severe OAT who underwent varicocelectomy according to WHO criteria 2021 (pre-operatively and at 6, 12, and 18 months post-operatively).
Results: The average age of our patients was 38.5 years. The mean spermatozoa concentration was found to be 1.60 ± 0.83 million/ml pre-operatively, while the mean post-operative concentration was 5.17 ± 1.23 million/ml at 6 months, 8.32 ± 0.98 million/ml at 12 months, and 13.51 ± 1.48 million/ml at 18 months (p < 0.0001). The mean percentage of A+B motile spermatozoa was 2.92 ± 1.17% pre-operatively, 6.10 ± 1.51% at six months, 9.58 ± 1.49 % at 12 months and 13.92 ± 1.88 % at 18 months postoperatively (p < 0.0001). The mean Modified David’s morphology score was 3.80 ± 1.43 % pre-operatively, and 5.95 ± 1.23 % at 6 months, 7.94 ± 1.18 %at 12 months and 10.82 ± 1.91% at 18 months post-operatively (p < 0.0001). The mean of TMSC was statistically improved after varicocelectomy (p < 0.001). The mean of DFI of the spermatozoa was 31.40 ± 0.52 % pre-operatively, and post-operatively at 28.20 ± 0.32 % at 6 months, 25.90 ± 0.31% at 12 months and 20.50 ± 0.40% at 18 months (p < 0.001).
Conclusions: Varicocelectomy was associated with significant improvement of sperm parameters and DNA fragmentation resulting in significant improvement of spermatogenesis quality. We believe that universalization in routinely use Sperm Dispersion Chromatin test could be beneficial in the treatment of infertility.
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