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Fertility and Sterility Oct 2020To study the global DNA methylation pattern in spermatozoa of patients with varicocele as well as investigate their semen quality.
OBJECTIVE
To study the global DNA methylation pattern in spermatozoa of patients with varicocele as well as investigate their semen quality.
DESIGN
Prospective observational case-control study.
SETTING
University-affiliated hospital.
PATIENT(S)
A total of 26 men with varicocele and 26 fertile men without the disorder.
INTERVENTIONS
Analysis of semen quality and sperm DNA methylation patterns.
MAIN OUTCOME MEASURE(S)
Semen quality evaluated by semen analysis, and sperm DNA methylation patterns investigated using the Infinium MethylationEPIC BeadChip platform.
RESULT(S)
Men with varicocele displayed decreased semen quality. The sperm DNA methylation analysis showed that men with varicocele exhibit global hypomethylation in comparison with the control group. A total of 59 differentially methylated CpG sites were identified, most of them hypomethylated in the varicocele group. In regional analyses, 1,695 DNA regions were differentially methylated in men with varicocele. These regions show associations with gamete generation, meiotic and meiosis cell cycle, and semen quality based on gene ontology analysis.
CONCLUSION(S)
Gene ontology results suggest that changes in methylation may be associated with the low semen quality phenotype observed in some varicocele patients because the observed differentially methylated regions in varicocele patients are related to male reproductive pathways. Additionally, the varicocele grade may influence the magnitude of global sperm DNA methylation change. To our knowledge, this is the first report analyzing changes at a regional or CpG-specific level in men with varicocele.
Topics: Adult; DNA Methylation; Humans; Male; Semen Analysis; Spermatozoa; Varicocele
PubMed: 32709382
DOI: 10.1016/j.fertnstert.2020.04.045 -
Annals of Medicine Dec 2023Vitamin A has multiple functions in the human body, being involved in growth, epithelial differentiation, vision, immune function and reproduction. While normal...
PURPOSE
Vitamin A has multiple functions in the human body, being involved in growth, epithelial differentiation, vision, immune function and reproduction. While normal spermatogenesis is influenced by several factors, it requires vitamin A. Systemic isotretinoin is a vitamin A derivative that is used in the treatment of many dermatological diseases, especially acne vulgaris (AV). There is limited research on the changes in semen parameters after systemic isotretinoin therapy in humans. Our study investigates the presence of varicoceles in patients undergoing systemic isotretinoin therapy for AV and examines whether there were any changes in the semen parameters before and after treatment.
METHODS
Included in the study were 46 men patients who were scheduled for systemic isotretinoin therapy for AV. Before treatment, the patients underwent a physical examination and ultrasonography for varicoceles assessment. The patients underwent spermiogram before treatment and after 6 months of treatment. The spermiogram assessments included semen volume, sperm concentration, total sperm count, progressive motility, viability and sperm morphology.
RESULTS
After treatment, there was an increase in semen volume, sperm concentration, total sperm count, progressive motility and vitality from the pre-treatment values, but a deterioration in the sperm morphology ( < .05). Comparing patients with and without varicoceles revealed more changes in semen parameters after treatment in those with varicoceles. There was a statistically significant difference in sperm concentration ( < .001).
CONCLUSIONS
Systemic isotretinoin therapy negatively affects sperm morphology, but has positive effect on other semen parameters, and these changes in semen parameters occur more frequently in patients with varicoceles.KEY MESSAGESAcne vulgaris is a very common disease and systemic isotretinoin is used as the most effective agent in its treatment.Systemic isotretinoin positively affects semen parameters except sperm morphology.Changes in semen parameters are more common in patients with varicocele.
Topics: Humans; Male; Semen; Isotretinoin; Infertility, Male; Varicocele; Vitamin A; Sperm Motility
PubMed: 37162375
DOI: 10.1080/07853890.2023.2207038 -
Asian Journal of Andrology 2016We summarize and comment on the topics discussed by the contributors to this Special Issue of . The scope of varicocele covers a wide spectrum, including proteomics and...
We summarize and comment on the topics discussed by the contributors to this Special Issue of . The scope of varicocele covers a wide spectrum, including proteomics and metabolomics, hormonal control, interventional therapy, and assisted reproductive technology (ART). The selection of topics demonstrates the exciting breadth of this thematic area and the opportunity research holds for both increasing the understanding and improving the reproductive health of males with varicocele.
Topics: Humans; Infertility, Male; Male; Reproductive Techniques, Assisted; Varicocele
PubMed: 26780876
DOI: 10.4103/1008-682X.172820 -
Medicinski Glasnik : Official... Aug 2015Despite many studies published in recent years concerning the relationship between demographic factors and varicocele, this issue remains controversial. The aim of this... (Comparative Study)
Comparative Study
AIM
Despite many studies published in recent years concerning the relationship between demographic factors and varicocele, this issue remains controversial. The aim of this study was to identify a possible influence of body mass index (BMI) and height on occurrence varicocele in men.
METHODS
In a case-control study 153 patients aged 18-40 years from 2004 to 20014, with moderate and sever varicocele were studied. The BMI and height of the 153 patients with varicocele were compared with 250 men who had no varicocele as a control group.
RESULTS
After the adjustment for socio-demographic factors, the risk of varicocele for obese men was lower than for overweight and normal men (OR= 0.38, 95% CI= 0.17, 0.85). The adjusted OR for varicocele in taller men was higher than in those with low height (OR= 3.42, 95% CI= 1.34, 8.72), and moderate height (OR=2.68, 95% CI= 1.12, 6.46).
CONCLUSION
The results of this study indicated that tall men and non-obese men may be at higher risk of varicocele, therefore counseling and evaluation of the men at high risk of varicocele may be of benefit for reduced infertility.
Topics: Adolescent; Adult; Body Height; Body Mass Index; Case-Control Studies; Humans; Male; Varicocele
PubMed: 26276662
DOI: 10.17392/788-15 -
Andrology Jan 2013Varicocoele is defined as excessive dilatation of the pampiniform venous plexus of the spermatic cord. Varicocoele frequently appears during early puberty and is... (Review)
Review
Varicocoele is defined as excessive dilatation of the pampiniform venous plexus of the spermatic cord. Varicocoele frequently appears during early puberty and is recognized to be the most common surgically correctable cause of male infertility. However, the actual incidence in adolescents, pathophysiology and the association with male factor infertility all remain somewhat controversial. The most accurate diagnostic technique for identifying young men who will benefit from surgical treatment has yet to be established. Observations of testicular asymmetry and deteriorating semen quality helped establish current guidelines and recommendations for surgical treatment. Further studies, comparing observation with surgical intervention, are needed to refine the current indications for varicocoele repair in the adolescent male.
Topics: Adolescent; Humans; Incidence; Male; Patient Selection; Practice Guidelines as Topic; Predictive Value of Tests; Risk Factors; Treatment Outcome; Urologic Surgical Procedures, Male; Varicocele
PubMed: 23258638
DOI: 10.1111/j.2047-2927.2012.00004.x -
International Journal of Medical... 2020To investigate the differences in clinical pregnancy, miscarriage, and live birth rates when male partners were diagnosed with a varicocele and to compare these... (Comparative Study)
Comparative Study
To investigate the differences in clinical pregnancy, miscarriage, and live birth rates when male partners were diagnosed with a varicocele and to compare these outcomes to those without and study the outcomes based on the grade of varicocele. The retrospective study was based on a cohort of consecutive infertile couples undergoing assisted reproductive technology (ART) at the Reproductive Center of Shandong Provincial Hospital affiliated to the Shandong University during the period between January 2017 and December 2018. A total of 4203 couples comprised of men with and without varicocele undergoing the first ART cycle (1501 intrauterine inseminations (IUI), 1623 fertilisations (IVF) and 1079 intracytoplasmic sperm injections (ICSI)) were included. Semen parameters and ART outcomes were determined. ICSI (26.5%) originated from men with a significant lower level in sperm concentration and motility but with a strict normal morphology had a higher prevalence of varicocele than men undergoing IUI (20.7%) and IVF (18.1%). In IUI, the odds ratios (ORs) for pregnancy and live birth were significantly lower for couples in men diagnosed with grades 1 or 2 varicocele as compared to those for men with grade 3 varicocele. In IVF, ORs for live birth where men were diagnosed with grades 1 or 2 varicocele were also lower than those for men with grade 3,whereas a higher miscarriage rate was found when men had grades 1 or 2 varicocele than when men had grade 3. However, for ICSI, no significant outcomes were found in grades 1, 2 or 3 varicocele versus the no varicocele group. The increasing grade of varicocele was negatively associated with sperm parameters and can alter the outcome of further IUI/IVF.
Topics: Abortion, Spontaneous; Adult; Female; Fertilization in Vitro; Humans; Infertility, Male; Insemination, Artificial; Live Birth; Male; Pregnancy; Pregnancy Rate; Prevalence; Retrospective Studies; Severity of Illness Index; Sperm Count; Sperm Injections, Intracytoplasmic; Treatment Outcome; Varicocele
PubMed: 32922176
DOI: 10.7150/ijms.48005 -
Asian Journal of Andrology 2016Varicocele affects approximately 35%-40% of men presenting for an infertility evaluation. There is fair evidence indicating that surgical repair of clinical varicocele... (Meta-Analysis)
Meta-Analysis Review
Varicocele affects approximately 35%-40% of men presenting for an infertility evaluation. There is fair evidence indicating that surgical repair of clinical varicocele improves semen parameters, decreases seminal oxidative stress and sperm DNA fragmentation, and increases the chances of natural conception. However, it is unclear whether performing varicocelectomy in men with clinical varicocele prior to assisted reproductive technology (ART) improve treatment outcomes. The objective of this study was to evaluate the role of varicocelectomy on ART pregnancy outcomes in nonazoospermic infertile men with clinical varicocele. An electronic search was performed to collect all evidence that fitted our eligibility criteria using the MEDLINE and EMBASE databases until April 2015. Four retrospective studies were included, all of which involved intracytoplasmic sperm injection (ICSI), and accounted for 870 cycles (438 subjected to ICSI with prior varicocelectomy, and 432 without prior varicocelectomy). There was a significant increase in the clinical pregnancy rates (OR = 1.59, 95% CI: 1.19-2.12, I 2 = 25%) and live birth rates (OR = 2.17, 95% CI: 1.55-3.06, I 2 = 0%) in the varicocelectomy group compared to the group subjected to ICSI without previous varicocelectomy. Our results indicate that performing varicocelectomy in patients with clinical varicocele prior to ICSI is associated with improved pregnancy outcomes.
Topics: Female; Humans; Infertility, Male; Male; Pregnancy; Reproductive Techniques, Assisted; Semen Analysis; Treatment Outcome; Varicocele
PubMed: 26510504
DOI: 10.4103/1008-682X.163269 -
Medicine Sep 2023Varicocele is a major cause of male infertility. However, few studies have discussed the potential associations between the pain caused by varicocele and preoperative...
Varicocele is a major cause of male infertility. However, few studies have discussed the potential associations between the pain caused by varicocele and preoperative and intraoperative factors. The aim of this study was to evaluate factors potentially associated with changes in pain score after microsurgical varicocelectomy. This retrospective study was conducted between August 2020 and August 2022 at China Medical University Hospital in Taichung, Taiwan. Patient characteristics including age, body mass index, semen analysis, testicular volume, and the number of veins ligated were collected. Preoperative and intraoperative factors were analyzed to determine if they were correlated with changes in numeric rating scale (NRS) after microsurgical varicocelectomy. A total of 44 patients with clinical varicocele underwent subinguinal microsurgical varicocelectomy and were analyzed. The overall pain resolution rate was 91%, and the average satisfaction score after surgery was 9.2 according to their subjective feelings. Multivariate analysis revealed that severe varicocele grade (odds ratio [OR] 16.5, 95% confidence interval [CI] 3.01-90.47; P = .018) and the number of veins ligated (OR 6, 95% CI 1.6-22.48; P = .013), were significantly associated with changes in NRS after surgery. In addition, the area under the receiver operating characteristic curve for changes in NRS and the total number of veins ligated was 0.869. Microsurgical varicocelectomy had a high success rate for scrotal pain and satisfaction. Severe varicocele grade and the number of veins ligated in microsurgical varicocelectomy were associated with postoperative pain improvement.
Topics: Humans; Male; Varicocele; Retrospective Studies; Vascular Surgical Procedures; Veins; Pelvic Pain
PubMed: 37746984
DOI: 10.1097/MD.0000000000035170 -
Andrology Mar 2021Varicocoele (VCL), one of the main causes of male subfertility, negatively affects testicular function. Due to limited access to human testicular tissue, animal model... (Review)
Review
BACKGROUND
Varicocoele (VCL), one of the main causes of male subfertility, negatively affects testicular function. Due to limited access to human testicular tissue, animal model studies have been used to evaluate molecular and, recently, epigenetic changes attributed to pathophysiology induced by VCL.
OBJECTIVES
This review aims to provide an update on the latest findings regarding the link between VCL-induced biochemical stress and molecular changes in germ cells and spermatozoa. Endocrine and antioxidant status, testicular chaperone-specific hemostasis failure, altered testicular ion balance, metabolic disorders, and altered carbon cycling during spermatogenesis are among the many features that will be presented.
DISCUSSION
Literature review coupled with our own findings suggests that ionic imbalance, hypoxia, hyperthermia, and altered blood flow could lead to severe chronic oxidative and nitrosative stress in patients with VCL leading to defective spermatogenesis and impairment of the integrity of all sperm cell components and compartments down to the epigenetic information they carry.
CONCLUSION
Since oxidative stress is an important feature of the reproductive pathology of VCL, therapeutic strategies such as the administration of appropriate antioxidants could be undertaken as a complementary non-invasive treatment line.
Topics: Animals; Epigenesis, Genetic; Heat-Shock Response; Humans; Ions; Male; Nitrogen; Oxidative Stress; Reactive Oxygen Species; Testis; Varicocele
PubMed: 33145958
DOI: 10.1111/andr.12940 -
Pediatric Surgery International May 2023To present our experience with robot-assisted laparoscopic varicocelectomy in a pediatric population.
PURPOSE
To present our experience with robot-assisted laparoscopic varicocelectomy in a pediatric population.
METHODS
We reviewed 49 consecutive cases performed by the same experienced surgeon. One-to-four veins were ligated at the internal ring of the inguinal canal, while the testicular artery and lymphatics were spared. Information on patient characteristics, surgical time, complications, and recurrences were collected.
RESULTS
Median patient age was 14 (range 10-17) years. Forty-eight had left-sided varicoceles and one had a bilateral varicocele. Forty-five were grade 3. All patients were referred due to discomfort/pain and 20 also had reduced testicular size. The median operating time from skin incision was 48 min (31-89 min) and the median console time was 18 min (7-55 min). Forty-seven patients were discharged the same day. Two patients experienced pain and problems urinating, respectively. These issues had resolved by the first post-operative day. There were no other complications, but at 6 months, eight recurrences were noted (16%). Scrotal complaints had subsided in all patients. Catch-up growth of the affected testicles was seen in 19/20 cases.
CONCLUSION
Robot-assisted laparoscopic varicocelectomy is feasible and safe in a pediatric population but with a relatively high recurrence rate.
Topics: Adolescent; Child; Humans; Male; Laparoscopy; Spermatic Cord; Treatment Outcome; Varicocele; Vascular Surgical Procedures; Robotic Surgical Procedures
PubMed: 37209246
DOI: 10.1007/s00383-023-05488-w