Division of Urology, Department of Surgery Related, Faculty of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan.
Syst Biol Reprod Med. 2012 Oct;58(5):274-7. doi: 10.3109/19396368.2012.692431. Epub 2012 Jul 2.
Varicocele is currently the most common irregularity identified in males that is associated with impaired spermatogenesis. It primarily presents in the form of decreased sperm count and motility, abnormal morphology, and significantly increased sperm DNA fragmentation. Several studies have shown that surgical repair improves semen parameters and increases the odds of spontaneous pregnancy. However the exact effect of surgical repair treatment remains controversial. Therefore, the aim of our study was to evaluate the effectiveness of microsurgical repair by comparing common semen parameters and sperm DNA fragmentation index (DFI). We evaluated infertile men (n = 19) who underwent microsurgical subinguinal varicocelectomy for treatment of clinical varicocele before and 3 months after surgery. Normozoospermic men (n = 19) were considered as the normal control group. Semen parameters improved significantly after surgery when compared with that before surgery, but still significant differences with the normal control group were observed. In comparison, sperm DNA integrity improved significantly after surgery (percentage DFI decreased from 28.4 ± 15.6% before surgery to 22.4 ± 12.9%, at 3 months post surgery) to similar levels as the normal control group. These results suggest that microsurgical repair may be considered as a treatment option in infertile men with palpable varicocele.
精索静脉曲张是目前男性最常见的与精子发生受损相关的异常。它主要表现为精子数量和活力下降、形态异常以及精子 DNA 碎片显著增加。几项研究表明，手术修复可改善精液参数并增加自然妊娠的几率。然而，手术修复治疗的确切效果仍存在争议。因此，我们的研究旨在通过比较常见的精液参数和精子 DNA 碎片指数（DFI）来评估显微外科修复的效果。我们评估了 19 名接受显微精索下静脉结扎术治疗临床精索静脉曲张的不育男性，手术前和手术后 3 个月分别进行评估。正常生育能力的男性（n=19）被视为正常对照组。与术前相比，术后精液参数明显改善，但仍与正常对照组存在显著差异。相比之下，术后精子 DNA 完整性明显改善（DFI 百分比从术前的 28.4±15.6%降至术后 3 个月的 22.4±12.9%），与正常对照组相似。这些结果表明，在可触及精索静脉曲张的不育男性中，显微外科修复可能被视为一种治疗选择。
