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Abstract(Please copy/paste the abstract send to the congress) : |
Objectives:
Male factor infertility accounts for 40-50% of infertility cases. Varicocele is the most frequent finding in infertile men. Although, this clinical condition can be associated with semen parameter alterations and infertility, the impact of varicocele repair on these complications is one of the most controversial issues.
Follicular stimulating hormone (FSH) plays a crucial role in spermatogenesis and sperm maturation. Some researchers have showed that in young men with varicocele, treatment with exogenous FSH leads to the significant improvement in the seminal fluid parameters. The exact mechanism is unclear, although reduction in reactive oxygen species (ROS) could be one of the possible mechanisms. We decided to evaluate the effectiveness of treatment with recombinant human follicle stimulating hormone (rhFSH) on semen parameters in subfertile men who underwent varicocele repair.
Methods:
A Multi-centeral, prospective, randomized and single-blinded controlled trial was conducted in IVF Ward, Moheb-e-Yas Hospital and Urology Research Center, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran, between 2011 and 2014. Ninety-six subfertile men affected with clinically idiopathic unilateral left-sided varicocele, abnormal semen parameters and surgically treated by varicocele repair have been selected. They were randomly allocated to the two groups after operation. Group I received rhFSH (Gonal-F; Merek Sereno, Aubonne, Switzerland) 75 IU i.m. three times per week for 13 weeks, while group II received no medical treatment after operation . Semen analyses were obtained at baseline and the end of treatment course. Student’s t-test was used for comparison of continuous variables, and chi-square test was used for comparison of proportions.
Results:
There were no differences in demographic characteristics between two groups. Semen parameters including; sperm concentration, motility and morphology were associated with improvement after treatment course, in both groups (ρ=0.001 , ρ=0.001 , ρ=0.002 , respectively, group I) and (ρ=0.043 , ρ=0.048 , ρ=0.037 , respectively, group II). In contrast to the statistically significant advantages in terms of sperm motility and morphology in group I compared to these values in group II (ρ=0.0001, ρ=0.0001, respectively), the increment in sperm concentration was not statistically significant between two groups (ρ=o.072).
Conclusion:
The data demonstrated that varicocelectomy in subfertile men with clinically palpable varicocele and impairment of seminal parameters is associated with improvement in these parameters.
In terms of sperm motility and morphology, there are the statistically significant advantages for post operation administration of rhFSH.
Key Words:
Infertility, Semen analysis, Varicocele, Varicocele repair, rhFSH |