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VARICOCELECTOMY IMPROVES INTRAUTERINE INSEMINATION SUCCESS RATES IN MEN WITH VARICOCELE

2001; Lippincott Williams & Wilkins; Volume: 165; Issue: 5 Linguagem: Inglês

10.1016/s0022-5347(05)66338-0

1527-3792

James A. Daitch, Mohamed A. Bedaiwy, Eleonora Bedin Pasqualotto, Benjamin N. Hendin, Jorge Hallak, Tommaso Falcone, Anthony J. Thomas, David R. Nelson, Ashok Agarwal,

Urological Disorders and Treatments

No AccessJournal of UrologyCLINICAL UROLOGY: Original Articles1 May 2001VARICOCELECTOMY IMPROVES INTRAUTERINE INSEMINATION SUCCESS RATES IN MEN WITH VARICOCELE JAMES A. DAITCH, MOHAMED A. BEDAIWY, ELEONORA B. PASQUALOTTO, BENJAMIN N. HENDIN, JORGE HALLAK, TOMMASO FALCONE, ANTHONY J. THOMAS, DAVID R. NELSON, and ASHOK AGARWAL JAMES A. DAITCHJAMES A. DAITCH , MOHAMED A. BEDAIWYMOHAMED A. BEDAIWY , ELEONORA B. PASQUALOTTOELEONORA B. PASQUALOTTO , BENJAMIN N. HENDINBENJAMIN N. HENDIN , JORGE HALLAKJORGE HALLAK , TOMMASO FALCONETOMMASO FALCONE , ANTHONY J. THOMASANTHONY J. THOMAS , DAVID R. NELSONDAVID R. NELSON , and ASHOK AGARWALASHOK AGARWAL View All Author Informationhttps://doi.org/10.1016/S0022-5347(05)66338-0AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We determined whether varicocele treatment before intrauterine insemination significantly affects intrauterine insemination success rates. Materials and Methods: A total of 58 infertile couples, of whom the women had normal evaluations and men had abnormal semen analyses and a history of varicocele, were included in this study. They were identified after reviewing the charts of all women undergoing intrauterine insemination for male factor infertility at our center. Of the men 24 participated in 63 intrauterine insemination cycles without varicocele treatment, while in the remaining 34 varicocele was treated before a total of 101 intrauterine insemination cycles. Variables associated with pregnancy or live birth were analyzed using repeat measures logistic regression with generalized estimating equation techniques. An initial stepwise generalized estimating equation was performed without including varicocele treatment status. Subsequently varicocele treatment status and the significant associated factors were included in analysis. The semen characteristics of untreated and treated varicocele groups were compared with repeat measures analysis of variance. Results: On pre-wash semen analysis patients with untreated varicocele had significantly higher mean motility plus or minus standard error than patients whose varicoceles were treated (48.6% ± 2.3% versus 38.1% ± 1.8%, p = 0.02). However, no statistically significant difference was noted in the mean post-wash total motile sperm count in the treated and untreated groups (7.2 ± 1.0 versus 14.8 ± 2.6, p = 0.1). Despite these findings the pregnancy and live birth rates per cycle were significantly higher in patients in whom varicocele was treated than in those without varicocele treatment (11.8% versus 6.3%, p = 0.04 and 11.8% versus 1.6%, p = 0.007, respectively). Conclusions: Varicocele treatment may not improve semen characteristics in all men but it appears to improve pregnancy and live birth rates among couples undergoing intrauterine insemination for male factor infertility. A functional factor not measured on routine semen analysis may affect pregnancy rates in this setting. Men should be screened for varicocele before intrauterine insemination is initiated for male factor infertility. References 1 : Infertility and the seeking of infertility treatment in a representative population. Br J Obstet Gynaecol1995; 102: 978. Google Scholar 2 : Sperm transport from the external cervical os to the fallopian tubes in women: a time and quantitation study. Fertil Steril1973; 24: 655. 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Google Scholar From the Center for Advanced Research in Human Reproduction and Infertility, Urological Institute, Departments of Gynecology-Obstetrics and Biostatistics and Epidemiology, Cleveland Clinic Foundation, Cleveland, Ohio© 2001 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byAl Bakri A, Lo K, Grober E, Cassidy D, Cardoso J and Jarvi K (2011) Time for Improvement in Semen Parameters After VaricocelectomyJournal of Urology, VOL. 187, NO. 1, (227-231), Online publication date: 1-Jan-2012.Esteves S, Oliveira F and Bertolla R (2010) Clinical Outcome of Intracytoplasmic Sperm Injection in Infertile Men With Treated and Untreated Clinical VaricoceleJournal of Urology, VOL. 184, NO. 4, (1442-1446), Online publication date: 1-Oct-2010.Hussein A (2018) The Role of Color Doppler Ultrasound in Prediction of the Outcome of Microsurgical Subinguinal VaricocelectomyJournal of Urology, VOL. 176, NO. 5, (2141-2145), Online publication date: 1-Nov-2006.PENSON D, PALTIEL A, KRUMHOLZ H and PALTER S (2018) The Cost-Effectiveness of Treatment for Varicocele Related InfertilityJournal of Urology, VOL. 168, NO. 6, (2490-2494), Online publication date: 1-Dec-2002. Volume 165Issue 5May 2001Page: 1510-1513 Advertisement Copyright & Permissions© 2001 by American Urological Association, Inc.Keywordsvaricoceleinfertility, malesemeninsemination, artificialscrotumMetricsAuthor Information JAMES A. DAITCH More articles by this author MOHAMED A. BEDAIWY More articles by this author ELEONORA B. PASQUALOTTO More articles by this author BENJAMIN N. HENDIN More articles by this author JORGE HALLAK More articles by this author TOMMASO FALCONE More articles by this author ANTHONY J. THOMAS More articles by this author DAVID R. NELSON More articles by this author ASHOK AGARWAL More articles by this author Expand All Advertisement PDF downloadLoading ...