Department of Urologic Surgery, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Reprod Biomed Online. 2012 Sep;25(3):307-14. doi: 10.1016/j.rbmo.2012.05.002. Epub 2012 May 23.
Varicocele, a cause of male infertility, occurs in nearly 40% of infertile males. It has been postulated that varicoceles may cause sperm DNA damage. Sperm DNA integrity has been recognized as one of the important determinants of normal fertilization and embryo growth in natural and assisted conception. Eighty-three human studies were identified after an extensive literature search involving the role of varicoceles in sperm DNA damage. Of the 83 studies, 12 were selected that measured similar types of reactive sperm DNA damage. Seven studies determined the damage of sperm DNA in varicocele-associated patients and six studies evaluated the efficacy of varicocelectomy. One study was a duplicate because both outcomes were included. Data were analysed using RevMan software. The overall estimate showed that patients with varicoceles have significantly higher sperm DNA damage than controls, with a mean difference of 9.84% (95% CI 9.19 to 10.49; P<0.00001). A varicocelectomy can improve sperm DNA integrity, with a mean difference of -3.37% (95% CI -4.09 to -2.65; P<0.00001). In conclusion, there is increased sperm DNA damage in patients with varicoceles and varicocelectomy may be a possible treatment; however, more studies with appropriate controls are needed to confirm this finding. A varicocele is an important cause of male infertility and occurs in nearly 40% of infertile males. The recent understanding of the effect of varicoceles in male reproduction has led some researchers to postulate varicoceles as the possible cause of sperm DNA damage. Eighty-three human studies were identified after an extensive literature search involving the role of varicoceles in sperm DNA damage. Of the 83 studies, 12 were selected that measured similar types of reactive sperm DNA damage by a similar method. Seven studies determined the damage of sperm DNA in varicocele-associated patients and six studies evaluated the efficacy of varicocelectomy. One study was a duplicate because both outcomes were included. The data were then entered in the RevMan software for analysis. The overall estimate showed that patients with varicoceles have significantly higher sperm DNA damage than controls, with a mean difference of 9.84% (95% CI 9.19 to 10.49; P<0.00001). A varicocelectomy can improve sperm DNA integrity, with a mean difference of -3.37% (95% CI -4.09 to -2.65; P<0.00001). Based on the results, it can be concluded that there is increased sperm DNA damage in patients with varicoceles and that varicocelectomy may be a possible treatment; however, more studies with appropriate controls are needed to confirm this finding.
精索静脉曲张是男性不育的一个原因，约 40%的不育男性存在精索静脉曲张。有人推测精索静脉曲张可能导致精子 DNA 损伤。精子 DNA 完整性已被认为是自然受孕和辅助受孕中正常受精和胚胎发育的重要决定因素之一。经过广泛的文献检索，共确定了 83 项涉及精索静脉曲张与精子 DNA 损伤关系的研究。在这 83 项研究中，选择了 12 项测量类似类型反应性精子 DNA 损伤的研究。7 项研究确定了精索静脉曲张相关患者精子 DNA 的损伤情况，6 项研究评估了精索静脉结扎术的疗效。有一项研究是重复的，因为两个结果都包括在内。使用 RevMan 软件分析数据。总体估计表明，精索静脉曲张患者的精子 DNA 损伤明显高于对照组，平均差异为 9.84%（95%CI9.19 至 10.49；P<0.00001）。精索静脉结扎术可以改善精子 DNA 完整性，平均差异为-3.37%（95%CI-4.09 至-2.65；P<0.00001）。总之，精索静脉曲张患者的精子 DNA 损伤增加，精索静脉结扎术可能是一种可行的治疗方法；然而，需要更多的研究来证实这一发现。精索静脉曲张是男性不育的一个重要原因，约 40%的不育男性存在精索静脉曲张。最近对精索静脉曲张在男性生殖中的作用的认识，使一些研究人员推测精索静脉曲张可能是精子 DNA 损伤的原因。经过广泛的文献检索，共确定了 83 项涉及精索静脉曲张与精子 DNA 损伤关系的研究。在这 83 项研究中，选择了 12 项测量类似类型反应性精子 DNA 损伤的研究。7 项研究确定了精索静脉曲张相关患者精子 DNA 的损伤情况，6 项研究评估了精索静脉结扎术的疗效。有一项研究是重复的，因为两个结果都包括在内。使用 RevMan 软件分析数据。总体估计表明，精索静脉曲张患者的精子 DNA 损伤明显高于对照组，平均差异为 9.84%（95%CI9.19 至 10.49；P<0.00001）。精索静脉结扎术可以改善精子 DNA 完整性，平均差异为-3.37%（95%CI-4.09 至-2.65；P<0.00001）。总之，精索静脉曲张患者的精子 DNA 损伤增加，精索静脉结扎术可能是一种可行的治疗方法；然而，需要更多的研究来证实这一发现。
