The World Journal of Men's Health (Jul 2024)

Impact of Varicocele on Testicular Oxidative Stress and Sperm Parameters in Experimental Animals: A Systematic Review and Meta-Analysis

  • Giorgio Ivan Russo,
  • Ramadan Saleh,
  • Federica Finocchi,
  • Almas Ramadhani Juma,
  • Damayanthi Durairajanayagam,
  • Oguzhan Kahraman,
  • Emrullah Söğütdelen,
  • Ioannis Sokolakis,
  • Ranjit B. Vishwakarma,
  • Fahmi Bahar,
  • Ahmed M. Harraz,
  • Parviz Kavoussi,
  • Widi Atmoko,
  • Eric Chung,
  • Naveen Kumar,
  • Wael Zohdy,
  • Amarnath Rambhatla,
  • Mohamed Arafa,
  • Nguyen Ho Vinh Phuoc,
  • Gianmaria Salvio,
  • Aldo E. Calogero,
  • Tuncay Toprak,
  • Germar-Michael Pinggera,
  • Rossella Cannarella,
  • Giovanni Colpi,
  • Taha Abo-Almagd Abdel-Meguid Hamoda,
  • Rupin Shah,
  • Ashok Agarwal

DOI
https://doi.org/10.5534/wjmh.230260
Journal volume & issue
Vol. 42, no. 3
pp. 563 – 573

Abstract

Read online

Purpose: Varicocele has been associated with high seminal oxidative stress (OS), impaired semen quality, and reduced male fertility potential. However, the exact mechanism(s) underlying the development of varicocele-mediated infertility and the cause-effect relationship between varicocele and testicular dysfunction are not fully understood. The aim of this systematic review and meta-analysis (SRMA) is to investigate the impact of varicocele on testicular OS markers and sperm parameters in experimental animals with varicocele as compared to animals without varicocele. Materials and Methods: A literature search was performed using the Scopus and PubMed databases on studies that investigated testicular OS markers and sperm parameters in animals with varicocele. The primary outcomes included malondialdehyde (MDA) (nmol/mg) levels whereas the secondary outcomes included total sperm count (×106), sperm vitality (%), total sperm motility (%), and sperm DNA fragmentation (SDF) (%). Standardized mean difference (SMD) (95% confidence interval [CI]) was chosen to express the effect size. The quality of the included studies was evaluated using the Cambridge Quality Checklist. Results: Out of 76 identified articles, 6 studies on rats were included in the meta-analysis. The analysis showed a significant increase of MDA (SMD: 15.61 [1.93, 29.29]; p=0.03) in rats with varicocele vs. controls. We also observed a significant decrease in total sperm count (SMD: -17.45 [-28.97, -5.93]; p<0.01), sperm vitality (SMD: -16.41 [-26.30, -6.52]; p<0.01), total sperm motility (SMD: -17.67 [-24.90, -10.44]; p<0.01), and a significant increase of SDF (SMD: 7.41 [1.23, 13.59]; p=0.02), in rats with varicocele vs. controls. The quality of the included studies was ranked as high. Conclusions: This SRMA indicates a significant increase in levels of testicular MDA and SDF and a reduction of sperm quality in experimental animals with varicocele. These findings support the potential role of testicular OS in the development of varicocele-induced testicular damage.

Keywords