Semen Parameters and Chromatin Packaging in Microsurgical Varicocelectomy Patients

Background: Varicocelectomy is considered as standard treatment for male infertility for clinicalvaricocele. The aim of this study is to address the effects of varicocelectomy on semen parameters,chromatin packaging, and pregnancy outcome.Materials and Methods: This retrospective study was carried out between June 2006 and February2011 on 145 infertile men with grade II or III varicocele. Microsurgical varicocelectomy wasperformed as part of patient management. Sperm count, motility, morphology, and chromatinpackaging were assessed with a Makler counting chamber, light microscopy, Papanicoulaou andchromomycin A3 (CMA3) staining, respectively. In addition, we assessed spontaneous clinicalpregnancy and miscarriage rates.Results: The percentages of spontaneous cumulative pregnancies post-surgery were 33.1% (3months), 42.06% (6 months), 46.2% (9 months), 48.9% (12 months), and 55.8% (after 12 months).Percentages of spontaneous cumulative miscarriage post-surgery were 2.46% (3 months), 4.93%(6 months), 4.93% (9 months), 6.17% (12 months), and 6.17 % (after 12 months). Both spermparameters improved and the percentage of sperm protamine deficiency decreased significantlyafter varicocelectomy.Conclusion: These results confirm that varicocelectomy improves sperm parameters and chromatinpackaging, thereby improving the chance of pregnancy. Positive aspects of this study include thelarge number of patients studied, duration of follow up, one surgeon who performed all of thesurgeries, and type of surgery (microsurgery). The spontaneous pregnancy results also suggest thatif pregnancy is not achieved within twelve months post-surgery, an alternative approach such asassisted reproductive technology (ART) treatment should be considered.