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  • Title: [Surgical treatment of varicocele improves fertility and facilitates medically assisted procreation].
    Author: Jallouli H, Hadj Slimen M, Sahnoun A, Kechou S, Ben Amar S, Bahloul A, Mhiri MN.
    Journal: Prog Urol; 2008 Sep; 18(8):543-9. PubMed ID: 18760746.
    Abstract:
    PURPOSE: To assess the effect of varicocelectomy in sperm quality and natural pregnancy and to determine if it can change couple candidacy for assisted reproductive technology (ART) procedures. MATERIALS AND METHODS: We performed a retrospective study about 164 infertile men with varicocele associated to sperm abnormalities. We divided our patients into four groups, according to the total motile sperm count (TMC). Group 1 includes 21 azoospermic men, group 2 includes 62 patients who had a TMC strictly less than 1.5x10(6), group 3 includes 22 patients who had a TMC between 1.5 and 5x10(6) and group 4 includes 59 patients who had a TMC strictly greater than 5x10(6). All patients underwent surgical or percutaneous embolisation to repair varicocele. RESULTS: After treatment, the mean spermatozoid concentration and motility were significantly increased, respectively from 24.8 to 29.2x10(6)spermatozoids per millilitre and 14.4 to 23.2%. Spontaneous pregnancy was observed in 59 couples (35.9%). Concerning the couples who had no pregnancies (105), 51 (48.5%) showed increase of the TMC, which allowed them to change the foreseen preoperative ART by an other one more simple. CONCLUSION: Varicocelectomy has a significant potential not only to improve sperm quality and natural pregnancy, but also to downstage the level of ART needed to male infertility management.
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