A Randomized Clinical Trial Study of the Effects of Varicocelectomy on Sperm Clinical Analysis and DNA Fragmentation: A Preliminary Data

Abstract

Varicocele is a disease characterized by abnormal dilatation of the testicular veins within the pampiniform plexus due to difficult blood return in this region. The prevalence of varicocele is 30 to 40% in infertile men, who frequently show seminal changes and a high rate of sperm DNA Fragmentation Index (DFI), one of the conditions responsible for failure of spermatogenesis. Several studies have demonstrated that varicocelectomy may improve the seminal parameters and even the quality of genetic material. However, published papers are predominantly retrospective rather than prospective. In this study, we show some effects of varicocelectomy on the seminal quality and DFI rate of men who were submitted compared to men who did not undergo the procedure, before and after nine months of the intervention. This preliminary data was a prospective, randomized and controlled clinical trial in which 15 men with varicocele and five men without varicocele (control group) were included. In the varicocele group, five patients were submitted to varicocelectomy and 10 were not. The DFI rate was analyzed using the Halosperm G2® kit and the seminal parameters were assessed according to the criteria established by the World Health Organization (WHO), 2010. A difference in DFI rate was detected between the varicocele (52% ± 0.28) and the control group (27% ± 0.07). In the varicocele group, no differences in DFI rate were observed between patients submitted to varicocelectomy and patients who were not submitted to the procedure, however, we could observe a sharp increase in the sperm concentration of patients who underwent surgery (28.33x 106/ml ± 26.91) compared with not submitted varicocelectomy (3.03 x 106/ml ± 14.74). These preliminary results emphasize that men with varicocele have a higher DFI rate.