EFFECT OF VARICOCELECTOMY ON SPERM DEOXYRIBONUCLEIC ACID FRAGMENTATION RATES AND SEMEN ANALYSIS

Tran Quoc Cuong1, Nguyen Trung Hieu2, Le Thanh Binh2, Nguyen Le Kha Ai3, Luong Tieu Yen4
1 1. Vinmec International General Hospital Can Tho
2 2. Can Tho University of Medicine and Pharmacy
3 3. Nam Can Tho University
4 4. Military Hospital 121

Main Article Content

Abstract

Objective: To evaluate changes in sperm DNA fragmentation rate and conventional semen parameters in male patients with varicocele before and after surgical treatment.


Subjects and methods: A systematic review of published systematic reviews and meta-analyses (overview of systematic reviews) together with primary studies on male patients with clinical varicocele who underwent surgical treatment (microsurgical or non-microsurgical varicocelectomy), with assessment of semen parameters and sperm DNA fragmentation rate before and at least 3 months after surgery.


Results: All included studies reported a statistically significant decrease in sperm DNA fragmentation rate after varicocelectomy, with a reduction ranging from 3% to 11% depending on the follow‑up time point. Semen parameters (sperm concentration, progressive motility, and morphology) also significantly improved after surgery, especially in the microsurgical varicocelectomy group.


Conclusion: Current evidence suggests a trend toward improvement in both sperm DNA fragmentation rate and conventional semen parameters after varicocelectomy in infertile men with clinical varicocele, particularly with the microsurgical technique. However, well‑standardized systematic reviews are needed to confirm these findings.

Article Details

References

[1]. Zhao CC, Scott M, Eisenberg ML. Male Fertility as a Proxy for Health. J Clin Med. 2024 Sep 19;13(18):5559. doi: 10.3390/jcm13185559.
[2]. Lewis SEM. Revisiting the impact of varicocele and its treatments on male fertility. Reprod Biomed Online. 2022 Dec;45(6):1061-1063. doi: 10.1016/j.rbmo.2022.07.004.
[3]. Alahmar AT, Singh R, Palani A. Sperm DNA Fragmentation in Reproductive Medicine: A Review. J Hum Reprod Sci. 2022 Jul-Sep;15(3):206-218. doi: 10.4103/jhrs.jhrs_82_22.
[4]. Fathi A, Mohamed O, Mahmoud O, et al. The impact of varicocelectomy on sperm DNA fragmentation and pregnancy rate in subfertile men with normal semen parameters: A pilot study. Arab J Urol. 2021 Feb 14;19(2):186-190. doi: 10.1080/2090598X.2021.1889746.
[5]. Cannarella R, Shah R, Saleh R, et al. Effects of Varicocele Repair on Sperm DNA Fragmentation and Seminal Malondialdehyde Levels in Infertile Men with Clinical Varicocele: A Systematic Review and Meta-Analysis. World J Mens Health. 2024 Apr;42(2):321-337. doi: 10.5534/wjmh.230235.
[6]. Lira Neto FT, Roque M, Esteves SC. Effect of varicocelectomy on sperm deoxyribonucleic acid fragmentation rates in infertile men with clinical varicocele: a systematic review and meta-analysis. Fertil Steril. 2021 Sep;116(3):696-712. doi: 10.1016/j.fertnstert.2021.04.003.
[7]. Gill K, Kups M, Harasny P, et al. The Negative Impact of Varicocele on Basic Semen Parameters, Sperm Nuclear DNA Dispersion and Oxidation-Reduction Potential in Semen. Int J Environ Res Public Health. 2021 Jun 2;18(11):5977. doi: 10.3390/ijerph18115977.
[8]. Kavoussi PK, Abdullah N, Gilkey MS, et al. The impact of ipsilateral testicular atrophy on semen quality and sperm DNA fragmentation response to varicocele repair. Asian J Androl. 2021 Mar-Apr;23(2):146-149. doi: 10.4103/aja.aja_50_20.
[9]. Rochdi C, Bellajdel I, El Moudane A, et al. The Effects of Varicocelectomy on Sperm DNA Fragmentation and Conventional Semen Parameters in Men with Severe Oligoasthenoteratozoospermia: A Prospective Study. Int J Fertil Steril. 2024 Jun 9;18(3):248-255. doi: 10.22074/ijfs.2023.2002260.1465.
[10]. Shomarufov A, Bozhedomov V, Fozilov A, et al. Sperm DNA Fragmentation in Infertile Men With Varicocele: Clinical Epidemiology and Comparative Assessment of Microsurgical Varicocelectomy and Antioxidant Therapy. Front Biosci (Schol Ed). 2025 Aug 29;17(3):33393. doi: 10.31083/FBS33393.