Jakob Damsgaard1, Ulla N Joensen1, Elisabeth Carlsen2, Juris Erenpreiss3, Martin Blomberg Jensen4, Valentinas Matulevicius5, Birute Zilaitiene5, Inge A Olesen1, Antti Perheentupa6, Margus Punab7, Andrea Salzbrunn8, Jorma Toppari9, Helena E Virtanen10, Anders Juul1, Niels E Skakkebæk1, Niels Jørgensen11. 1. University Department of Growth and Reproduction, Rigshospitalet, and International Research and Research Training Centre in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark. 2. Department of Fertility, Rigshospitalet, Copenhagen, Denmark. 3. Biomedicine Study and Research Center, Riga, Latvia. 4. University Department of Growth and Reproduction, Rigshospitalet, and International Research and Research Training Centre in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark; Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, MA, USA. 5. Institute of Endocrinology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania. 6. Institute of Biomedicine, Department of Physiology, University of Turku, and Department of Obstetrics and Gynaecology, Turku University Hospital, Turku, Finland. 7. Andrology Unit, Tartu University Hospital, Tartu, Estonia. 8. Department of Andrology, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany. 9. Department of Physiology, Institute of Biomedicine, University of Turku, and Department of Paediatrics, Turku University Hospital, Turku, Finland. 10. Department of Physiology, Institute of Biomedicine, University of Turku, Turku, Finland. 11. University Department of Growth and Reproduction, Rigshospitalet, and International Research and Research Training Centre in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark. Electronic address: Niels.Joergensen@regionh.dk.
Abstract
BACKGROUND: Present knowledge on the impact of varicoceles on testicular function is largely based on studies of subfertile and infertile men, making it difficult to extrapolate the impact of varicocele on the general population. OBJECTIVE: To describe associations between varicocele and testicular function assessed by semen analysis and reproductive hormones in men from the general population. DESIGN, SETTING, AND PARTICIPANTS: A cross-sectional multicentre study of 7035 young men, median age 19 yr, from the general population in six European countries (Denmark, Finland, Germany, Estonia, Latvia, and Lithuania) were investigated from 1996 to 2010. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: We analysed results from physical examination, conventional semen variables, and serum reproductive hormones using multivariable regression analyses. RESULTS AND LIMITATIONS: A total of 1102 (15.7%) had grade 1-3 varicocele. Increasing varicocele grade was associated with poorer semen quality, even in grade 1 varicocele. In grade 3 varicocele, sperm concentration was less than half of that in men with no varicocele. Presence of varicocele was also associated with higher serum levels of follicle-stimulating hormone, lower inhibin B, and higher levels of luteinising hormone; testosterone and free testosterone were not significantly different between men with and without varicocele. This study cannot draw a conclusion on the progressiveness of varicocele or the effect of treatment. CONCLUSIONS: We demonstrated an adverse effect of increasing grade of varicocele on testicular function in men not selected due to fertility status. PATIENT SUMMARY: The presence and increasing grade of varicocele is adversely associated with semen quality and reproductive hormone levels in young men from the general population.
BACKGROUND: Present knowledge on the impact of varicoceles on testicular function is largely based on studies of subfertile and infertile men, making it difficult to extrapolate the impact of varicocele on the general population. OBJECTIVE: To describe associations between varicocele and testicular function assessed by semen analysis and reproductive hormones in men from the general population. DESIGN, SETTING, AND PARTICIPANTS: A cross-sectional multicentre study of 7035 young men, median age 19 yr, from the general population in six European countries (Denmark, Finland, Germany, Estonia, Latvia, and Lithuania) were investigated from 1996 to 2010. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: We analysed results from physical examination, conventional semen variables, and serum reproductive hormones using multivariable regression analyses. RESULTS AND LIMITATIONS: A total of 1102 (15.7%) had grade 1-3 varicocele. Increasing varicocele grade was associated with poorer semen quality, even in grade 1 varicocele. In grade 3 varicocele, sperm concentration was less than half of that in men with no varicocele. Presence of varicocele was also associated with higher serum levels of follicle-stimulating hormone, lower inhibin B, and higher levels of luteinising hormone; testosterone and free testosterone were not significantly different between men with and without varicocele. This study cannot draw a conclusion on the progressiveness of varicocele or the effect of treatment. CONCLUSIONS: We demonstrated an adverse effect of increasing grade of varicocele on testicular function in men not selected due to fertility status. PATIENT SUMMARY: The presence and increasing grade of varicocele is adversely associated with semen quality and reproductive hormone levels in young men from the general population.
Authors: Nannan Thirumavalavan; Jason M Scovell; Adithya Balasubramanian; Taylor P Kohn; Byung Ji; Asad Hasan; Alexander W Pastuszak; Larry I Lipshultz Journal: Urology Date: 2018-07-05 Impact factor: 2.649
Authors: Christian Fuglesang S Jensen; Peter Østergren; James M Dupree; Dana A Ohl; Jens Sønksen; Mikkel Fode Journal: Nat Rev Urol Date: 2017-07-04 Impact factor: 14.432
Authors: Jason P Van Batavia; Elizabeth Lawton; Jennifer R Frazier; Stephen A Zderic; Mark R Zaontz; Aseem R Shukla; Arun K Srinivasan; Dana A Weiss; Christopher J Long; Douglas A Canning; Thomas F Kolon Journal: J Urol Date: 2020-10-07 Impact factor: 7.450