Fertility Rate and Sperm DNA Fragmentation Index following Varicocelectomy in Primary Infertile Men with Clinical Varicocele: A Prospective Longitudinal Study

Document Type : Original Article


1 Urology Research Center, Razi Hospital, Guilan University of Medical Sciences, Rasht, Iran

2 Department of Urology, Labbafinejad Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, IranTehran university of medical science

3 Pars Hospital, Rasht, Iran

4 Department of Urology, Hasheminejad Kidney Center, Iran University of Medical Sciences, Tehran, Iran


Background: Varicocele is one of the most common treatable causes of male infertility, and its treatment may be
beneficial for fertility. This study aimed to evaluate fertility rate and DNA fragmentation index (DFI) following varicocelectomy
in primary infertile men with clinical varicocele.
Materials and Methods: This prospective longitudinal study was conducted on primary infertility men, in a tertiary
center from December 2018 to December 2019 with one-year follow-up. Data of the semen parameters, DFI (%), and
fertility rate were gathered before, as well as 4 and 12 months after undergoing varicocelectomy. For data analysis,
SPSS software and analytical test were used.
Results: Out of 76 patients who were analyzed, 22 (29%) became fertile and 54 (71%) remained infertile. Semen
parameters and DFI (%) were improved significantly following varicocelectomy (P<0.001). Smoking history, occupational
heated exposure, body mass index (BMI), and infertility duration were determined as predictors associated
with fertility status (P<0.05).
Conclusion: Although varicocele repair improved the DFI, the fertility rate was achieved in less than one-third of
patients; it seems that the other parameters, such as the history of smoking, occupational heated exposure, overweight,
and duration of infertility should be considered as predictors of fertility status, in primary infertile men who are a candidate
for varicocelectomy.


Main Subjects


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