Spontaneous pregnancy rates in Chinese men undergoing microsurgical subinguinal varicocelectomy and possible preoperative factors affecting the outcomes.

OBJECTIVE

To investigate pregnancy rates after microsurgical varicocelectomy in Chinese infertile men with clinical varicoceles and to identify preoperative factors affecting the outcomes.

DESIGN

Retrospective data analysis.

SETTING

University infertility clinic.

PATIENT(S): One hundred seventy-six consecutive Chinese men with infertility and clinical varicoceles who underwent varicocelectomy from January 2010 to December 2011. Semen data were available for 145 patients, and pregnancy data were available for 66.

INTERVENTION(S): Varicocelectomy was performed on all patients.

MAIN OUTCOME MEASURE(S): Spontaneous pregnancy rates and improvement in semen parameters after varicocelectomy.

RESULT(S): We followed 145 men (82.4%) for a median of 21 months (range 12-36 months) after varicocelectomy. For 109 patients (75.2%), both sperm concentration and forward motility improved. Overall, 45.5% (66/145) of female partners achieved spontaneous pregnancy at a mean follow-up of 11.7 ± 6.2 months. On univariate analysis, preoperative high sperm concentration (≥20 million/mL) and high sperm motility (≥25%) were positively associated with spontaneous pregnancy. On multivariate analysis, only preoperative sperm concentration was an independent predictor.

CONCLUSION(S): Microsurgical varicocelectomy could improve semen quality and spontaneous pregnancy rates. Only preoperative sperm concentration was an independent predictor of spontaneous pregnancy. Patients with high initial sperm concentration may benefit from varicocelectomy for spontaneous pregnancy.