Seminal fluid analysis changes after testicular varicocelectomy in a sample of Iraqi patients


Background: Semen analysis measures ejaculate volume, pH, sperm count, motility, forward progression, and morphology. Although semen analysis is not a test for infertility, it is considered the most important laboratory test in the evaluation of male fertility. There are many factors affecting the seminal fluid parameters and testicular varicocele is one of them. Varicoceles are the most commonly seen and correctable male infertility factor. Varicocelectomy is a common operation performed for infertile males with clinical varicocele. The aim of study to evaluate the seminal fluid parameters changes after testicular varicocelectomy. Patients and Method: A prospective cohort study was done at the Al Sader Medical City in Najaf during the period from (March-October 2019). The study include 30 males with age between 18 and 32 years old who had a clinical varicocele. Seminal fluid analysis was done one before surgery and another one three months after surgery and compare between the two tests to evaluate the changes in the parameters was done, which include seminal fluid liquefaction, volume, color, PH, sperm concentration, motility and morphology. Results: There were 30 patients enrolled in this study with a mean age of 23.8 ± 3.36. Seminal fluid concentration was 19.1 ± 7.2 million/ml and it was significantly increased postoperatively by almost 84% than preoperative concentration to reach 35.1 ± 11.3 (P ≤ 0.001). The changes in progressive motile sperms’ percent improved after varicocelectomy but not reach the statistical significance (P≥0.935). The mean ± SD percent of normal morphology sperms percent preoperatively was 46.9 ± 22.9 %, and after operation, it elevated to 50.9 ± 18.6 (p value≥ 0.336 ).The patients is divided in to two subgroups (normospermic and oligospermic subgroup). Conclusion: There is a significant improvement in sperm concentration. While there is significant improvement in sperm concentration in oligospermic subgroup, so the infertile patient who has oligospermia with varicocele will get better outcome after varicocelectomy.