Computer-assisted semen analysis parameters in men with varicocele: is surgery helpful?

OBJECTIVE

To assess sperm characteristics and fertility before and after varicocelectomy using computer-assisted semen analysis (CASA).

DESIGN

Preoperative and postoperative sperm parameters of infertile men with varicocele were analyzed statistically and the outcome of pregnancy was determined.

SETTING

Department of Infertility Management and Assisted Reproduction, Jaslok Hospital and Research Centre, Bombay.

PATIENTS

Semen samples of 49 men with varicocele-related infertility were analyzed using CASA.

INTERVENTIONS

Sperm parameters of 26 men who underwent varicocelectomy were evaluated 3, 6, and 9 months postoperatively. Conception, occurring either naturally or therapeutically, was recorded.

MAIN OUTCOME MEASURES

Evaluation of improvement of sperm parameters after surgery.

RESULTS

Sperm count, motility parameters, curvilinear velocity, straightline velocity, lateral head displacement, and normal morphology were significantly lower in men with varicocele. Postoperatively, there was significant improvement in count, motility, and normal morphology, with a decrease in proportion of acrosome-deficient heads and tapering forms. After varicocelectomy, 46.2% of the men had normal semen parameters, with the overall pregnancy rate being 50%.

CONCLUSIONS

Computer-assisted semen analysis provides the potential for accurate quantitative evaluation of semen in men with varicocele. Varicocelectomy results in improvement in semen quality with pregnancy rates of 50%.