ABSTRACT

Hong Kong Med J 2013;19:334–40 | Number 4, August 2013 | Epub 6 May 2013
DOI: 10.12809/hkmj133884
ORIGINAL ARTICLE
Subinguinal microsurgical varicocelectomy for male factor subfertility: ten-year experience
L Leung, KL Ho, PC Tam, MK Yiu
Department of Surgery, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong
 
 
OBJECTIVE. To investigate the impact of subinguinal microsurgical varicocelectomy on semen parameters and pregnancy outcomes in couples with male factor subfertility.
 
DESIGN. Case series.
 
SETTING. Male Infertility Clinic in an academic institution in Hong Kong.
 
PATIENTS. The clinical records of 42 consecutive subfertile male patients who had subinguinal microsurgical varicocelectomy (from January 2000 to December 2009) were retrospectively reviewed. All the patients had a known history of subfertility and abnormalities in one or more semen parameters. Female subfertility factors were not addressed. Only grade 2 or higher clinically palpable varicoceles were operated on.
 
MAIN OUTCOME MEASURES. Preoperative and postoperative semen analyses based on the World Health Organization criteria; the outcome measures included changes in semen parameters and whether a pregnancy ensued.
 
RESULTS. The mean age of patients and their spouses were 38 and 33 years, respectively. The mean duration of infertility was 4 years; 37 patients had primary infertility and five had secondary infertility. The mean (± standard deviation) sperm concentration improved from 12 ± 19 million/mL to 23 ± 29 million/mL following varicocelectomy (P
 
CONCLUSIONS. In couples with male infertility due to varicoceles, subinguinal microsurgical varicocelectomy was shown to improve sperm concentrations, motility and morphology, and the likelihood of a pregnancy. Spontaneous pregnancy was achieved in 25% of the couples in which the man had severe oligospermia.
 
Key words: Azoospermia; Infertility, male; Microsurgery; Oligospermia; Varicocele
 
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