A Randomized Clinical Trial Study of the Effects of Varicocelectomy on Sperm Clinical Analysis and DNA Fragmentation: A Preliminary Data
DOI:
https://doi.org/10.17140/GOROJ-2-107Keywords:
Varicocele, Varicocelectomy, DNA fragmentation, Spermatozoa, Seminal parametersAbstract
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.
References
Weidner W, Pilatz A, Altinkilic B. Andrology: varicocele: an update. Urologe A. 2010; 49:163-165. doi: 10.1007/s00120-010- -2374-9
Choi WS, Kim SW. Current issues in varicocele management: a review. World J Mens Health. 2013; 31: 12-20. doi: 10.5534/ wjmh.2013.31.1.12
MacLeod J. Seminal cytology in the presence of varicocele. Fertil and steril. 1965; 16(6): 735-757.
Xue J, Yang J, Yan J, et al. Abnormalities of the testes and se-men parameters in clinical varicocele. J South Med Univ. 2012; 32: 439-442.
Kadioglu TC, Aliyev E, Celtik M. Microscopic varicocelecto-my significantly decreases the sperm dna fragmentation index in patients with infertility. BioMed Research International. 2014; 2014: 1-4. doi: 10.1155/2014/695713
Marmar JL. The pathophysiology of varicoceles in the light of current molecular and genetic information. Hum Reprod Up-date. 2001; 7(5): 461-472.
Masson P, Brannigan RE. The Varicocele. Urol Clin N Am. 2014; 41: 129-144. doi: 10.1016/j.ucl.2013.08.001
Zini A, Bielecki R, Phang D, Zenzes MT. Correlations be-tween two markers of sperm DNA integrity, DNA denaturation and DNA fragmentation, in fertile and infertile men. Fertil and Steril. 2001; 75(4): 674-677. doi: 10.1016/S0015-0282- (00)01796-9
Seidel Jr GE. Maintaining integrity of germline DNA: in-dividuals age, species do not. Reprod Fertil Dev. 2015. doi:
1071/RD14514 10. Shiraishi K, Matsuyama H, Takihara H. Pathophysiology of varicocele in male infertility in the era of assisted reproduc-tive technology. Int J Urol. 2012; 19(6): 538-550. doi: 10.1111/ j.1442-2042.2012.02982.x
Wang YJ, Zhang RQ, Lin YJ, Zhang RG, Zhang WL. Rela-tionship between varicocele and sperm DNA damage and the ef-fect of varicocele repair: a meta-analysis. Reproductive BioMed Online. 2012; 25: 307-314. doi: 10.1016/j.rbmo.2012.05.002
Enciso M, Muriel L, Fernández JL, et al. Infertile men with varicocele show a high relativa proportion of soerm cells with intensive nuclear damage level, evidenced by the sperm chro-matin dispersion test. J Androl. 2006; 27: 106-111. doi: 10.2164/ jandrol.05115
Zini A, Blumenfeld A, Libman J, Willis J. Beneficial effect of microsurgical varicocelectomy on human sperm DNA integ-rity. Hum Reprod. 2005; 20: 1018-1021. doi: 10.1093/humrep/ deh701
Grasso M, Lania C, Blanco S, Confalonieri S, Grasso AA. Efficacy of spermatic vein ligation in patients affected by high grade left varicocele. Int Braz J Urol. 2014; 40: 62-66. doi: 10.1590/S1677-5538.IBJU.2014.01.09
World Health Organization. WHO Laboratory Manual for the Examination and Processing of Human Semen. 5th ed. Geneva, Switzerland: World Health Organization; 2010. Website: http:// whqlibdoc.who.int/publications/2010/9789241547789_eng.pdf
Elder K, Dale B. In vitro fertilization. 2nd ed. New York, USA: Cambridge University Press; 2000: 133.
Fernández JL, Muriel L, Goyanes V, et al. Simple determi-nation of sperm DNA fragmentation with an improved Sperm Chromatin Dispersion (SCD) test. Fertil Steril. 2005; 84: 833- 842. doi: 10.1016/j.fertnstert.2004.11.089
Aitken RJ, de Iuliis GN, McLachlan RI. Biological and clini-cal significance of DNA damage in the male germ line. Int J An-drol. 2008; 32: 46-56. doi: 10.1111/j.1365-2605.2008.00943.x
Sakkas D, Seli E, Bizzaro D, Tarozzi N, Manicardi GC. Abnormal spermatozoa in the ejaculate: abortive apoptosis and faulty nuclear remodeling during spermatogenesis. Reprod Biomed Online. 2003; 7: 428-432. doi: 10.1016/S1472-6483- (10)61886-X
Schulze-Osthoff K, Walczak H, Droge W, Krammer PH. Cell nucleus and DNA fragmentation are not required for apoptosis. J Cell Biol. 1994; 127(1): 15-20.
Smith R, Kaune1 H, Parodi1 D, et al. Increased sperm DNA damage in patients with varicocele: relationship with seminal oxidative stress. Hum Reprod. 2006; 121(4): 986-993.
Koksal IT, Usta M, Orhan I, Abbasoglu S, Kadioglu A. Po-tential role of reactive oxygen species on testicular pathology associated with infertility. Asian J Androl. 2003; 5: 95-99.
Sakkas D, Alvarez JG. Sperm DNA fragmentation: mecha-nisms of origin, impact on reproductive outcome, and analy-sis. Fertil Steril. 2010; 93(4): 1027-1036. doi: 10.1016/j. fertnstert.2009.10.046
Agarwal A, Deepinder F, Cocuzza M, et al. Efficacy of Vari-cocelectomy in Improving Semen Parameters: New Meta-ana-lytical Approach. Urology. 2007; 70(3): 532-538. doi: 10.1016/j. urology.2007.04.011
Tavalaee M, Bahreinian M, Barekat F, Abbasi H, Nasr-Esfa-hani MH. Effect of varicocelectomy on sperm functional charac-teristics and DNA methylation. Andrologia. 2014; xx: 1-6.
Blumer CG, Restelli AE, Giudice PT, et al. Effect of vari-cocele on sperm function and semen oxidative stress. BJU Int. 2012; 109: 259-265. doi: 10.1111/j.1464-410X.2011.10240.x
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