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  • Title: Time to improvement in semen parameters after microsurgical varicocelectomy in men with severe oligospermia.
    Author: Masterson TA, Greer AB, Ramasamy R.
    Journal: Can Urol Assoc J; 2019 Mar; 13(3):E66-E69. PubMed ID: 30169150.
    Abstract:
    INTRODUCTION: We aimed to determine the time and predictive factors of semen quality improvement in men with severe oligospermia after microsurgical varicocelectomy. METHODS: Men with total motile sperm count (TMSC) <5 million on two semen analyses were identified from May 2015 to August 2017. Postoperative semen analysis was collected at 3-6 months and >6 months. We evaluated preoperative factors for successful semen quality upgrading based on assisted reproductive technology (ART) eligibility: in vitro fertilization [IVF] (<5 million), intrauterine insemination (IUI) (5-9 million), and natural pregnancy (>9 million). We compared men with TMSC <5 million to those with TMSC 5-9 million. Data are reported as means and standard error of the mean (SEM). Pregnancy data was collected by phone interview at >6 months postoperatively RESULTS: A total of 33 men were included. TMSC improved from 1.5±0.2 to 7.3±1.8 million at 3-6 months (p<0.05) and 12.2±3.6 million at >6 months (p<0.05). There was no statistical difference in TMSC between 3-6 months and >6 months. Sixteen (48.5%) men upgraded semen quality into the range of natural pregnancy. Preoperative TMSC from 2-5 million was predictive of upgrading semen quality. Twenty-four couples were contacted by phone; 20 were attempting pregnancy in the postoperative period and five (25%) of them had achieved natural pregnancy. CONCLUSIONS: Men with TMSC <5 million can expect the largest improvement in TMSC from 3-6 months postoperatively with minimal improvement thereafter. Preoperative TMSC >2 million was most predictive of semen quality upgrading.
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