The Effect of Subclinical Varicocele on Pregnancy Rates and Semen Parameters: a Systematic Review and Meta-Analysis

Current Urology Reports
Taylor P KohnAlexander W Pastuszak

Abstract

Current guidelines recommend against surgical repair of subclinical varicoceles (SCVs) for infertility; several studies demonstrate mixed fertility results after SCV correction. To determine whether surgical correction of SCV improves semen parameters and/or reproductive outcomes, we performed a systematic review and meta-analysis. Seven biomedical literature databases were searched through January 2018 for studies that assessed reproductive outcomes and/or change in semen parameters in men with corrected SCV compared to either (1) uncorrected SCV or (2) corrected clinical varicocele. Estimates were pooled using random-effects meta-analysis. Data were extracted from 13 studies involving 1357 men. Overall, the risk of bias for included studies was high and without a consistent SCV definition across studies. Surgical correction of SCV was associated with a minor increase in sperm density and total motile sperm count (TMSC) compared to uncorrected SCV. This increase in semen parameters is not clinically significant, as men prior to varicocelectomy were on average normospermic nor was correction of a SCV associated with an increase in pregnancy rates when compared to men with uncorrected SCV. Comparing corrected SCV to corrected cl...Continue Reading

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Citations

Jan 5, 2019·Obesity Reviews : an Official Journal of the International Association for the Study of Obesity·Almudena Carneiro-BarreraGualberto Buela-Casal
May 20, 2020·Research and Reports in Urology·Jaden R KohnTaylor P Kohn
Mar 4, 2021·Scientific Reports·Giulia CollodelElena Moretti
Apr 23, 2021·Asian Journal of Andrology·Patricia S ChoDavid A Diamond
Jul 29, 2021·Explore : the Journal of Science and Healing·Yanyan ZhangXiaojun Chen

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