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

Abstract

Background: Varicocele is one of the most common treatable causes of male infertility, and its treatment may bebeneficial for fertility. This study aimed to evaluate fertility rate and DNA fragmentation index (DFI) following varicocelectomyin primary infertile men with clinical varicocele.Materials and Methods: This prospective longitudinal study was conducted on primary infertility men, in a tertiarycenter from December 2018 to December 2019 with one-year follow-up. Data of the semen parameters, DFI (%), andfertility 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. Semenparameters and DFI (%) were improved significantly following varicocelectomy (P<0.001). Smoking history, occupationalheated exposure, body mass index (BMI), and infertility duration were determined as predictors associatedwith fertility status (P<0.05).Conclusion: Although varicocele repair improved the DFI, the fertility rate was achieved in less than one-third ofpatients; 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 candidatefor varicocelectomy.

Keywords

• dna fragmentation
• infertility
• semen analysis
• varicocele
• varicocelecto