Effect of performing varicocelectomy before intracytoplasmic sperm injection on clinical outcomes in non-azoospermic males.

OBJECTIVE

To compare laboratory outcomes and pregnancy rates of infertile couples, in which male partners have treated and untreated clinical varicocele before performing ICSI.

MATERIALS AND METHODS

The data of 306 couples in whom ICSI was performed due to infertility were evaluated retrospectively. All of the males had clinical varicocele, and patients were evaluated in two groups. Group A (n = 168) included patients who underwent successful varicocele repair and Group B (n = 138) included patients with clinical varicocele at the time of ICSI and no history of varicocele repair. Semen analysis, demographic factors and live birth and pregnancy rates were recorded.

RESULTS

There were 168 patients (54.9 %) in group A and 138 patients (45.1 %) group B. Groups were similar for demographic factors. Semen analysis results were significantly better after varicocelectomy. Pregnancy rates were higher in group A (62.5 vs. 47.1 %, p = 0.001). Live birth rates were also higher in group A (47.6 vs. 29.0 %, p = 0.0002). In the logistic regression analysis, varicocelectomy was found to increase the rates of viable pregnancy (OR 2.02, 95 % CI 1.25-3.87; p = 0.032), live births (OR 2.12, 95 % CI 1.26-3.97; p = 0.026).

CONCLUSION

Performing varicocelectomy improves the pregnancy and live birth rates by ICSI in infertile couples in whom the male partner has clinical varicocele. Varicocelectomy should be offered before ICSI to infertile men with clinical varicocele. However, further prospective randomized studies are needed to confirm benefit of varicocelectomy before ICSI.