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Andrologia Nov 2022The aim of this systematic review and meta-analysis was to assess whether oral antioxidant supplementation improves sperm quality in men with infertility and varicocele... (Meta-Analysis)
Meta-Analysis Review
Improvement in sperm quality by oral antioxidant supplementation in infertile men with varicocele who have not undergone surgical repair: Systematic review and meta-analysis.
The aim of this systematic review and meta-analysis was to assess whether oral antioxidant supplementation improves sperm quality in men with infertility and varicocele (VCL) who have not undergone surgical repair. In men with infertility and VCL who had not undergone surgical repair oral antioxidant supplementation significantly increased sperm concentration (WMD +5.86 × 10 /ml 95% CI: +1.47 to +10.24, p < 0.01; random effects model, six studies, 213 patients), total motility (WMD + 3.76%, 95% CI: +0.18 to +7.34, p = 0.04; random effects model, three studies, 93 patients), progressive motility (WMD + 6.38%, 95% CI: +3.04 to +9.71, p < 0.01; random effects model, three studies, 84 patients) and seminal volume (WMD +0.55 ml, 95%CI: +0.06 to +1.04, p = 0.03; random effects model, four studies, 120 patients). On the other hand, no significance difference was observed in sperm morphology (WMD +3.89%, 95% CI: -0.14 to +7.92, p = 0.06; random effects model, five studies, 187 patients). In conclusion, limited evidence suggests that the use of oral antioxidants in men with infertility and VCL, who have not undergone surgical repair improves their seminal volume, sperm concentration, total and progressive motility.
Topics: Antioxidants; Dietary Supplements; Humans; Infertility, Male; Male; Semen; Sperm Count; Sperm Motility; Spermatozoa; Varicocele
PubMed: 35819022
DOI: 10.1111/and.14533 -
Archives of Razi Institute Jul 2021The current study aimed to determine the effect of metformin (MET) on histopathologic evaluation and antioxidant enzyme activity in experimental varicocele-induced rats....
The current study aimed to determine the effect of metformin (MET) on histopathologic evaluation and antioxidant enzyme activity in experimental varicocele-induced rats. A total of 60 rats were randomly divided into six experimental groups. Group 1 (control) received no medication and underwent no surgery. In group 2 (sham), the rats received no medication and the abdominal cavity was opened; however, there was no varicocele induction. In group 3 (varicocele), the abdominal cavity was opened and the rats underwent varicocele induction and received no medication. In group 4, the abdominal cavity was opened and the animals received 25 mg/kg of MET for 42 days and were varicocele-induced. Groups 5 and 6 were similar to group 4 except that the animals received 50 and 100 mg/kg of MET, respectively. At the end of the 21st and 42nd days, the rats were euthanized and the left testis was removed for histological analysis and measurement of superoxide dismutase (SOD), malondialdehyde (MDA), glutathione peroxidase (GPx), and total antioxidant status levels. According to the results, a dose-dependent difference was observed in testis damage grade in the MET treated groups, compared to that reported for the varicocele group (p <0.05). No difference was observed between 25 and 50 mg/kg of MET (P>0.05). Tissue MDA levels significantly increased in varicocele rats (p <0.05); however, MET (25, 50, and 100 mg/kg) in a dose-dependent manner decreased varicocele-induced MDA (p <0.05). Experimental varicocele significantly decreased SOD activity, compared to that reported for the control group (p <0.05). The administration of MET (25, 50, and 100 mg/kg) significantly increased tissue SOD activity in varicocele rats (p <0.05). The MET (25, 50, and 100 mg/kg) in a dose-dependent manner increased GPx activity in varicocele rats (p <0.05). There was no difference in MDA, SOD, and GPx levels between 25 and 50 mg/kg MET groups (P>0.05). The aforementioned findings suggested that MET treatment had beneficial effects on varicocele.
Topics: Animals; Male; Rats; Malondialdehyde; Metformin; Rats, Wistar; Testis; Varicocele
PubMed: 34223735
DOI: 10.22092/ari.2020.128136.1406 -
F&S Science Aug 2023To study the relationship between the seminal sample quality of men with varicocele and sperm capacitation. (Observational Study)
Observational Study
OBJECTIVE
To study the relationship between the seminal sample quality of men with varicocele and sperm capacitation.
DESIGN
Cross-sectional observational study.
SETTING
Academic hospital.
PATIENT(S)
Seventy-six men (19 control and 57 with varicocele) were analyzed.
INTERVENTION(S)
Semen samples were submitted to a discontinuous density gradient for sperm selection. Sperm capacitation was induced using a human tubal fluid medium supplemented with bovine serum albumin.
MAIN OUTCOME MEASURE(S)
After capacitation induction, the sperm were assessed by capacitation state, computer-assisted sperm motility, mitochondrial activity, membrane integrity, acrosome reaction, and intracellular oxidative stress.
RESULT(S)
The capacitation period increased sperm motility, showing an increase in the average path velocity and a decrease in the straightness compared with sperm before capacitation (paired analysis). After capacitation, the rate of capacitated sperm, motility, and mitochondrial activity showed differences between groups (control and varicocele). The varicocele group showed lower mitochondrial activity and capacitation than the control group. On the other hand, no significant differences were observed in the other variables evaluated.
CONCLUSION(S)
Varicocele men showed less viable sperm and mitochondrial activity than control men after capacitation sperm. The induction of capacitation altered motility by increasing path velocity and decreasing straightness in all of the studied groups, evidencing the occurrence of hyperactivation.
Topics: Humans; Male; Semen; Sperm Capacitation; Sperm Motility; Varicocele; Cross-Sectional Studies
PubMed: 37169221
DOI: 10.1016/j.xfss.2023.05.001 -
International Journal of Molecular... Aug 2023Many natural substances commonly found in healthy diets have been studied for their potential to reduce male infertility associated with varicocele. A positive role of...
Many natural substances commonly found in healthy diets have been studied for their potential to reduce male infertility associated with varicocele. A positive role of selenium (Se) or lycopene alone was demonstrated in experimental varicocele, while no data are available on their association. One group of male Sprague-Dawley rats was sham operated and daily treated with Se (3 mg/kg, i.p.), lycopene (1 mg/kg, i.p.), or their association. A second group underwent surgery to induce varicocele. Sham and half of the varicocele animals were sacrificed after twenty-eight days, while the residual animals were treated for one more month and then sacrificed. In varicocele animals, testosterone levels and testes weight were reduced, Hypoxia Inducible Factor-1α (HIF-1α) expression was absent in the tubules and increased in Leydig cells, caspare-3 was increased, seminiferous epithelium showed evident structural changes, and many apoptotic germ cells were demonstrated with TUNEL assay. The treatment with lycopene or Se alone significantly increased testis weight and testosterone levels, reduced apoptosis and caspase-3 expression, improved the tubular organization, decreased HIF-1α positivity of Leydig cells, and restored its tubular positivity. Lycopene or Se association showed a better influence on all biochemical and morphological parameters. Therefore, the nutraceutical association of lycopene plus Se might be considered a possible therapeutic tool, together with surgery, in the treatment of male infertility. However, long-term experimental and clinical studies are necessary to evaluate sperm quantity and quality.
Topics: Male; Rats; Animals; Humans; Rats, Sprague-Dawley; Selenium; Lycopene; Varicocele; Semen; Dietary Supplements; Infertility, Male; Testosterone
PubMed: 37686330
DOI: 10.3390/ijms241713526 -
European Urology Focus Nov 2019Male factor infertility plays a significant role in infertility. Many factors have been associated with male infertility; however, the link between many sports and... (Review)
Review
CONTEXT
Male factor infertility plays a significant role in infertility. Many factors have been associated with male infertility; however, the link between many sports and recreational factors and male reproduction remains poorly characterized.
OBJECTIVE
To evaluate the current literature regarding the impact of many common sports and recreational factors on male reproduction.
EVIDENCE ACQUISITION
A comprehensive PubMed and Embase search for relevant articles published between 1970 and 2017 was performed by combining the following search terms: male, sports (including individual sports), traumatic brain injury, sauna, hot tub, fertility, erectile dysfunction, varicocele, environment, cell phone, and laptop computer.
EVIDENCE SYNTHESIS
Hypogonadism and erectile dysfunction can be associated with sports with high rates of head injuries, such as American football. Although early reports linked other sports, such as bicycling, to erectile dysfunction, subsequent studies isolated these associations to sports cycling rather than recreational cycling. Certain sports (football, basketball, handball, and volleyball) were linked to increasing prevalence and severity of varicocele, offering a potential link to male infertility. In addition, recreational activities such as sauna, hot tubs, Jacuzzis, heated car seats, and laptop use were associated with high testicular temperature, which can impair spermatogenesis. Radio frequency electromagnetic waves from cell phones and laptops have also been shown to have deleterious effects on sperm viability and motility.
CONCLUSIONS
Many common sports and daily activities represent potential sources of male infertility. Clinicians should be aware of these associations in explaining idiopathic infertility in males.
PATIENT SUMMARY
Male infertility is an often overlooked component of a couple's inability to conceive. We outline many common and often overlooked sports and recreational exposures that have been associated with male infertility.
Topics: Adult; Aged; Awareness; Bicycling; Brain Injuries, Traumatic; Cell Phone; Electromagnetic Radiation; Erectile Dysfunction; Hot Temperature; Humans; Hypogonadism; Infertility, Male; Male; Middle Aged; Prevalence; Semen Analysis; Severity of Illness Index; Spermatogenesis; Sports; Steam Bath; Varicocele
PubMed: 29731401
DOI: 10.1016/j.euf.2018.04.013 -
Reproductive Sciences (Thousand Oaks,... Jan 2021The evaluation of the seminal plasma plays a relevant role in the definition of male infertility and in assisted reproduction outcomes; for this reason, it would be... (Comparative Study)
Comparative Study
The evaluation of the seminal plasma plays a relevant role in the definition of male infertility and in assisted reproduction outcomes; for this reason, it would be recommended to find biochemical markers able to characterize sperm pathology. In this study, 53 infertile patients (grouped by the presence leukocytospermia, idiopathic infertility, or varicocele) and 10 fertile men were selected. Spermiogram was performed by light microscopy, and sperm ultrastructure was evaluated by transmission electron microscopy (TEM) mathematically elaborated. Testosterone (TESTO), estradiol (E2), ferritin (FERR), iron (Fe), transferrin (TRSF), triglycerides (TRG), cholesterol (CHOL), and isoprostanes (F-IsoPs) were detected in seminal plasma. Sperm characteristics and biochemical components were correlated by Spearman's rank correlation coefficient in the whole population and in each group. The levels of TESTO and E2 were positively correlated with sperm quality in particular, and E2 was correlated with fertility index expressing the number of sperm free of ultrastructural defects evaluated by TEM. On the contrary, the indices of iron metabolism (FERR, Fe, and TRSF) were positively associated with low sperm quality and sperm necrosis, particularly in leukocytospermia and varicocele groups, pathologies in which an inflammatory status and oxidative stress condition are present. The study of the seminal plasma composition deserves attention because the levels of the various components seem to be associated with specific reproductive pathologies.
Topics: Adult; Biomarkers; Case-Control Studies; Diagnosis, Differential; Estradiol; F2-Isoprostanes; Ferritins; Fertility; Humans; Infertility, Male; Iron; Lipids; Male; Microscopy, Electron, Transmission; Necrosis; Predictive Value of Tests; Semen; Sperm Count; Sperm Motility; Spermatogenesis; Spermatozoa; Testosterone; Transferrin; Varicocele
PubMed: 32696238
DOI: 10.1007/s43032-020-00260-0 -
Journal of the College of Physicians... Jul 2022To investigate the testicular parenchymal changes in patients with varicocele using shear wave elastography (SWE).
OBJECTIVE
To investigate the testicular parenchymal changes in patients with varicocele using shear wave elastography (SWE).
STUDY DESIGN
Cross-sectional study.
PLACE AND DURATION OF STUDY
Department of Radiology, Hatay Mustafa Kemal, School of Medicine, Hatay, Turkey, between June and August 2021.
METHODOLOGY
The study was conducted on 124 testes of 62 patients who had undergone scrotal ultrasonography. Using the SWE technique, the mean velocity and stiffness values of each testis were measured and recorded, and varicocele volume was calculated by measuring testis volume and the Pampiniform plexus (pp) vein diameter on Doppler examination. After the exclusion criteria, 55 (44.3%) testes with varicocele and 69 (55.6%) testes without varicocele were examined. The relationship between the SWE values of testis volume and the presence and volume of varicocele was evaluated statistically.
RESULTS
The mean velocity value was 0.76 ± 0.08 m/s in the varicocele group and 0.85 ± 0.13 m/s in the without varicocele group; the mean stiffness value was 1.76 ± 0.37 KPa in the varicocele group and 2.25 ± 0.54 KPa in the without varicocele group. The SWE values were found to be significantly lower in testes with varicocele than in those without (p<0.001). The mean testis volume was 13.5 ± 4.6 in the varicocele group and 13.8 ± 4.4 in the without varicocele group. No statistically significant relationship was determined between the presence of varicocele and testis volume (p=0.670). A significant negative correlation was found between plexus pampiniform diameter and velocity (rs=-0.405, p=0.002) and stiffness (rs =-0.399, p=0.003) values.
CONCLUSION
SWE findings can provide information about testicular damage associated with varicocele. Furthermore comprehensive studies may be of importance in varicocele treatment.
KEY WORDS
Shearwave elastography (SWE), Testis, Varicocele, Parenchymal stiffness.
Topics: Cross-Sectional Studies; Elasticity Imaging Techniques; Humans; Male; Testis; Ultrasonography; Varicocele
PubMed: 35795931
DOI: 10.29271/jcpsp.2022.07.855 -
European Urology Focus May 2023The outcomes and morbidity following treatment for persistent or varicocele recurrence remain controversial. (Review)
Review
CONTEXT
The outcomes and morbidity following treatment for persistent or varicocele recurrence remain controversial.
OBJECTIVE
To conduct a systematic review relating to the outcomes following treatment (any surgical or radiological) for varicocele persistence/recurrence.
EVIDENCE ACQUISITION
A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses statement. Prospective and retrospective observational or interventional studies were included until March 2022. Outcomes were pregnancy rate, improvements in semen parameters after treatment compared with those at baseline, pain control, complication rates, and repeat treatment approach. Men of any age with any-grade persistent/recurrent varicoceles were included.
EVIDENCE SYNTHESIS
Of 913 articles identified, 18 with 1073 patients were eligible for inclusion. The mean time between the first and repeat treatment ranged between 5.3 and 73.3 months. The indication for repeat treatment was infertility in eight and pain control in six out of 18 studies, whereas four did not provide details for the indication. Of the patients with recurrent/persistent varicoceles initially treated using a radiological intervention, 83.8% underwent another radiological procedure, whereas 16.2% underwent a surgical procedure. Of those initially treated with a surgical procedure, 77.8% underwent a further surgical procedure, whereas 22.2% underwent a radiological procedure. The rate of success of repeat treatment was 60-100%. The reported complications were as follows: hydrocele (up to 16%), testicular atrophy (up to 2%), scrotal hematoma (up to 1.6%), wound infection (up to 6.6%), chronic pain (up to 2.9%), injury to other organs (up to 10%), and thrombophlebitis (up to 5.8%). The rate of symptom resolution was >90% for pain control. Pregnancy rates were 17-58% at 12-month follow-up. Semen parameters improved after repeat treatment compared with that at baseline in 87.5% of studies. The main limitations are the high risk of bias according to the Newcastle and Ottawa Scale, heterogeneity of the included studies, and small simple size.
CONCLUSIONS
Treating any grade of persistent/recurrent varicoceles has a good rate of success, pregnancy, and pain control, but there is still a risk of complications. Repeat treatment with the same interventional modality is feasible. The level of evidence is overall low.
PATIENT SUMMARY
In this systematic review on persistent or recurrent varicoceles, we showed that repeat treatment with radiological or surgical procedures was feasible, with good success, pregnancy, and pain control rates at follow-up. However, repeat treatment was associated with a higher risk of complications than reported in the published literature relating to patients having their first intervention.
Topics: Male; Pregnancy; Female; Humans; Varicocele; Retrospective Studies; Prospective Studies; Pregnancy Rate; Chronic Pain
PubMed: 36443199
DOI: 10.1016/j.euf.2022.11.008 -
Actas Urologicas Espanolas Nov 2022To study the impact of loupe assisted subinguinal varicocelectomy on semen quality, serum testosterone level, and spontaneous pregnancy rate. (Review)
Review
OBJECTIVES
To study the impact of loupe assisted subinguinal varicocelectomy on semen quality, serum testosterone level, and spontaneous pregnancy rate.
METHODS
The data were prospectively collected for 102 infertile men with clinical varicocele. The preoperative values of semen analysis parameters and serum testosterone level were compared with postoperative values at 6 months. Spontaneous pregnancy was assessed at 6 months.
RESULTS
The mean age of patients was 31.56 ± 4.31 years. Primary infertility was reported in 86 patients, while 16 had secondary infertility. Bilateral varicocele was seen in 79 patients while 23 had a unilateral varicocele. The total sperm concentration (×10/mL) before and after varicocelectomy was 12.82 ± 3.91 and 20.06 ± 2.13 respectively (P < .0001). The total sperm motility (%) before and after varicocelectomy was 37.67 ± 7.23 and 55.46 ± 4.51 respectively (P < .0001). The sperm morphology (Kruger/Strict morphology criteria, %) before and after varicocelectomy was 3.11 ± 0.80 and 3.70 ± 0.78 respectively (P < .0001). The serum testosterone level (ng/dL) before and after varicocelectomy was 323.90 ± 67.81 and 396.74 ± 40.88 respectively (P < .0001). The Spontaneous pregnancy rate in couples with primary and secondary infertility was 18.60% and 31.25% respectively. The difference in their rates was not significant (P = .251). The overall spontaneous pregnancy rate was 20.5%.
CONCLUSION
Loupe-assisted sub-inguinal varicocelectomy is a safe and effective modality for treating infertile men, particularly when provision for microscopic surgery is unavailable. However, only large size comparative studies or multi-centric trials can confirm this.
Topics: Pregnancy; Female; Male; Humans; Adult; Varicocele; Semen Analysis; Sperm Motility; Feasibility Studies; Microsurgery; Semen; Infertility, Male; Testosterone
PubMed: 35210200
DOI: 10.1016/j.acuroe.2022.02.005 -
International Journal of Urology :... Aug 2022To explore the relationship between body mass index and varicocele, the range of body mass index that leads to increased odds of varicocele, and the association between...
OBJECTIVES
To explore the relationship between body mass index and varicocele, the range of body mass index that leads to increased odds of varicocele, and the association between body mass index with the position and grade of varicocele.
METHODS
We conducted a cross-sectional study of 211 989 Chinese males aged 18-65 years participated in the National Free Pre-conception Check-up Projects from January 2013 to December 2018. Univariate and multivariate logistic regression models were constructed to assess the association between body mass index and varicocele.
RESULTS
Overweight and obese males had 13.1% (odds ratio 0.869, 95% confidence interval 0.838-0.902) and 32.3% (odds ratio 0.677, 95% confidence interval 0.632-0.725) lower odds of varicocele than those with normal body mass index, respectively. The association between them was non-linear, and males with body mass index of 17.74 to 23.09 kg/m had an increased odds of varicocele. The overweight and obese males had lower odds of left and bilateral varicocele, but the right varicocele odds was increased by 63.3% in obese males.
CONCLUSION
Body mass index was associated with the odds of varicocele among reproductive-age males, but the odds varied by position. The effects of weight management and varicocele on fertility should be taken into account in fertility guidance.
Topics: Body Mass Index; China; Cross-Sectional Studies; Humans; Male; Obesity; Overweight; Varicocele
PubMed: 35483962
DOI: 10.1111/iju.14915