Summary evidence on the effects of varicocele treatment to improve natural fertility in subfertile men

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art_TISEO_Summary_evidence_on_the_effects_of_varicocele_treatment_2016.PDF (247.72 KB)
Citações na Scopus
44
Tipo de produção
article
Data de publicação
2016
Editora
MEDKNOW PUBLICATIONS & MEDIA PVT LTD
DOI
Indexadores
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Autores
ESTEVES, Sandro C.
Autor de Grupo de pesquisa
Editores
Coordenadores
Organizadores
Citação
ASIAN JOURNAL OF ANDROLOGY, v.18, n.2, p.239-245, 2016
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
The objective of this review was to summarize the evidence concerning the benefit of varicocele treatment to improve natural fertility in subfertile males. We also analyzed the effect of varicocele treatment on conventional semen parameters and sperm functional tests. An electronic search to collect the data was performed using the PubMed/MEDLINE databases until July 2015. Data pooled from a variety of study designs indicate that varicocelectomy improves semen parameters in the majority of the treated men with clinical varicocele and abnormal semen parameters regardless of the chosen surgical method. Surgical varicocele repair was beneficial not only for alleviating oxidative stress-associated infertility but also to improve sperm nuclear DNA integrity. However, given the low magnitude of the effect size in sperm DNA integrity, further research is needed to elucidate its clinical significance. Conflicting results on the effect of varicocele treatment on natural fertility seem to be due to heterogeneous study designs and, more importantly, patient selection criteria. When these issues are controlled, current evidence indicates that treatment of subclinical varicocele is not warranted, as it does not seem to improve fertility. On the contrary, fair evidence indicates that varicocele treatment should be offered to infertile patients with palpable varicocele and abnormal semen parameters. This evidence supports the current guidelines issued by the American Urological Association and European Association of Urology, which state that varicocele treatment should be offered to male partners of infertile couples presenting for evaluation with clinical varicocele and semen parameters alterations.
Palavras-chave
male infertility, review, treatment outcome varicocele, varicocelectomy
URI
https://observatorio.fm.usp.br/handle/OPI/14006
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Coleções
Artigos e Materiais de Revistas Científicas - HC/ICHC
Artigos e Materiais de Revistas Científicas - LIM/55