Time for improvement in semen parameters after varicocelectomy

Abstract

Purpose: While there are a number of studies documenting a positive effect of varicocelectomy on semen parameters, the length of time required following varicocelectomy for semen quality to improve is not well established. Therefore, in this study we identified the changes with time in semen parameters after varicocelectomy.

Materials and methods: The records and database of 304 patients who underwent varicocele repair for subfertility were reviewed retrospectively. All men had at least 2 preoperative semen analyses as well as semen testing at 3 and 6 months postoperatively.

Results: For the 100 patients who met the study inclusion criteria mean sperm counts increased significantly by 3 and 6 months after varicocelectomy (by 53% and 38% by 3 and 6 months, p = 0.0003 and 0.001, respectively). By 3 and 6 months the combined groups had a mean 2.5 and 1.5-fold higher total motile count compared to the preoperative total motile count, respectively. There was no further improvement in semen parameters in those men followed for more than 6 months. There were no statistically significant differences in the improvement in semen volume, motility, count or total motile count comparing the results at 3, 6 and more than 9 months postoperatively.

Conclusions: Sperm parameters improve by 3 months after varicocele repair and then do not improve further. This finding should allow physicians to decide quickly if varicocelectomy has been effective and, then, if required, plan on the use of other therapies to manage the couples' infertility.