Jing Peng1, Zhichao Zhang2, Wanshou Cui1, Yiming Yuan1, Weidong Song1, Bing Gao1, Zhongcheng Xin1, Sainan Zhu3. 1. Andrology Center, Peking University First Hospital, Beijing, People's Republic of China. 2. Andrology Center, Peking University First Hospital, Beijing, People's Republic of China. Electronic address: zhangzhichao@bjmu.edu.cn. 3. Department of Biostatistics, Peking University First Hospital, Beijing, People's Republic of China.
Abstract
OBJECTIVE: To investigate pregnancy rates after microsurgical varicocelectomy in Chinese infertile men with clinical varicoceles and to identify preoperative factors affecting the outcomes. DESIGN: Retrospective data analysis. SETTING: University infertility clinic. PATIENT(S): One hundred seventy-six consecutive Chinese men with infertility and clinical varicoceles who underwent varicocelectomy from January 2010 to December 2011. Semen data were available for 145 patients, and pregnancy data were available for 66. INTERVENTION(S): Varicocelectomy was performed on all patients. MAIN OUTCOME MEASURE(S): Spontaneous pregnancy rates and improvement in semen parameters after varicocelectomy. RESULT(S): We followed 145 men (82.4%) for a median of 21 months (range 12-36 months) after varicocelectomy. For 109 patients (75.2%), both sperm concentration and forward motility improved. Overall, 45.5% (66/145) of female partners achieved spontaneous pregnancy at a mean follow-up of 11.7 ± 6.2 months. On univariate analysis, preoperative high sperm concentration (≥20 million/mL) and high sperm motility (≥25%) were positively associated with spontaneous pregnancy. On multivariate analysis, only preoperative sperm concentration was an independent predictor. CONCLUSION(S): Microsurgical varicocelectomy could improve semen quality and spontaneous pregnancy rates. Only preoperative sperm concentration was an independent predictor of spontaneous pregnancy. Patients with high initial sperm concentration may benefit from varicocelectomy for spontaneous pregnancy.
OBJECTIVE: To investigate pregnancy rates after microsurgical varicocelectomy in Chinese infertilemen with clinical varicoceles and to identify preoperative factors affecting the outcomes. DESIGN: Retrospective data analysis. SETTING: University infertility clinic. PATIENT(S): One hundred seventy-six consecutive Chinese men with infertility and clinical varicoceles who underwent varicocelectomy from January 2010 to December 2011. Semen data were available for 145 patients, and pregnancy data were available for 66. INTERVENTION(S): Varicocelectomy was performed on all patients. MAIN OUTCOME MEASURE(S): Spontaneous pregnancy rates and improvement in semen parameters after varicocelectomy. RESULT(S): We followed 145 men (82.4%) for a median of 21 months (range 12-36 months) after varicocelectomy. For 109 patients (75.2%), both sperm concentration and forward motility improved. Overall, 45.5% (66/145) of female partners achieved spontaneous pregnancy at a mean follow-up of 11.7 ± 6.2 months. On univariate analysis, preoperative high sperm concentration (≥20 million/mL) and high sperm motility (≥25%) were positively associated with spontaneous pregnancy. On multivariate analysis, only preoperative sperm concentration was an independent predictor. CONCLUSION(S): Microsurgical varicocelectomy could improve semen quality and spontaneous pregnancy rates. Only preoperative sperm concentration was an independent predictor of spontaneous pregnancy. Patients with high initial sperm concentration may benefit from varicocelectomy for spontaneous pregnancy.