Impact of varicocele repair on semen parameters in infertile men: A systematic review and meta-analysis

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dc.authorid0000-0002-9976-9666
dc.authorid0000-0002-6308-1763
dc.contributor.authorAgarwal, Ashok
dc.contributor.authorCannarella, Rossella
dc.contributor.authorSaleh, Ramadan
dc.contributor.authorBoitrelle, Florence
dc.contributor.authorGül, Murat
dc.contributor.authorToprak, Tuncay
dc.contributor.authorSalvio, Gianmaria
dc.contributor.authorArafa, Mohamed
dc.contributor.authorRusso, Giorgio I.
dc.contributor.authorHarraz, Ahmed M.
dc.contributor.authorSingh, Rajender
dc.contributor.authorGarrido, Nicolas
dc.contributor.authorAbdel-Meguid Hamoda, Taha Abo-Almagd
dc.contributor.authorRambhatla, Amarnath
dc.contributor.authorKavoussi, Parviz
dc.contributor.authorKuroda, Shinnosuke
dc.contributor.authorÇalik, Gökhan
dc.contributor.authorSaini, Pallavi
dc.contributor.authorCeyhan, Erman
dc.contributor.authorDimitriadis, Fotios
dc.contributor.authorHenkel, Ralf
dc.contributor.authorCrafa, Andrea
dc.contributor.authorPalani, Ayad
dc.contributor.authorDuran, Mesut Berkan
dc.contributor.authorMaziotis, Evangelos
dc.contributor.authorMaziotis, Evangelos
dc.contributor.authorBendayan, Marion
dc.contributor.authorDarbandi, Mahsa
dc.contributor.authorLe, Tan V.
dc.contributor.authorGunes, Sezgin
dc.contributor.authorTsioulou, Petroula
dc.contributor.authorSengupta, Pallav
dc.contributor.authorHazir, Berk
dc.contributor.authorÇeker, Gökhan
dc.contributor.authorDarbandi, Sara
dc.contributor.authorDurairajanayagam, Damayanthi
dc.contributor.authorAghamajidi, Azin
dc.contributor.authorAlkhalidi, Noora
dc.contributor.authorSogutdelen, Emrullah
dc.contributor.authorLeisegang, Kristian
dc.contributor.authorAlarbid, Abdullah
dc.contributor.authorHo, Christopher C.K.
dc.contributor.authorMalhotra, Vineet
dc.contributor.authorFinocchi, Federica
dc.contributor.authorCrisóstomo, Luís
dc.contributor.authorKosgi, Raghavender
dc.contributor.authorElBardisi, Haitham
dc.contributor.authorZini, Armand
dc.contributor.authorBirowo, Ponco
dc.contributor.authorColpi, Giovanni
dc.contributor.authorPark, Hyun Jun
dc.contributor.authorSerefoglu, Ege Can
dc.contributor.authorNguyen, Quang
dc.contributor.authorKo, Edmund
dc.contributor.authorde la Rosette, Jean J. M. C. H.
dc.contributor.authorPinggera, Germar M.
dc.contributor.authorNguyen, Ho Vinh Phuoc
dc.contributor.authorKandil, Hussein
dc.contributor.authorShah, Rupin
dc.date.accessioned2023-02-14T10:53:04Z
dc.date.available2023-02-14T10:53:04Z
dc.date.issued2023
dc.departmentİstanbul Medipol Üniversitesi, Tıp Fakültesi, Cerrahi Tıp Bilimleri Bölümü, Üroloji Ana Bilim Dalı
dc.description.abstractPurpose: Despite the significant role of varicocele in the pathogenesis of male infertility, the impact of varicocele repair (VR) on conventional semen parameters remains controversial. Only a few systematic reviews and meta-analyses (SRMAs) have evaluated the impact of VR on sperm concentration, total motility, and progressive motility, mostly using a before-after analytic approach. No SRMA to date has evaluated the change in conventional semen parameters after VR compared to untreated controls. This study aimed to evaluate the effect of VR on conventional semen parameters in infertile patients with clinical varicocele compared to untreated controls. Materials and Methods: A literature search was performed using Scopus, PubMed, Embase, and Cochrane databases following the Population Intervention Comparison Outcome (PICOS) model (Population: infertile patients with clinical varicocele; Intervention: VR [any technique]; Comparison: infertile patients with clinical varicocele that were untreated; Outcome: sperm concentration, sperm total count, progressive sperm motility, total sperm motility, sperm morphology, and semen volume; Study type: randomized controlled trials and observational studies). Results: A total of 1,632 abstracts were initially assessed for eligibility. Sixteen studies were finally included with a total of 2,420 infertile men with clinical varicocele (1,424 patients treated with VR vs. 996 untreated controls). The analysis showed significantly improved post-operative semen parameters in patients compared to controls with regards to sperm concentration (standardized mean difference [SMD] 1.739; 95% CI 1.129 to 2.349; p<0.001; I2=97.6%), total sperm count (SMD 1.894; 95% CI 0.566 to 3.222; p<0.05; I2=97.8%), progressive sperm motility (SMD 3.301; 95% CI 2.164 to 4.437; p<0.01; I2=98.5%), total sperm motility (SMD 0.887; 95% CI 0.036 to 1.738; p=0.04; I2=97.3%) and normal sperm morphology (SMD 1.673; 95% CI 0.876 to 2.470; p<0.05; I2=98.5%). All the outcomes showed a high inter-study heterogeneity, but the sensitivity analysis showed that no study was sensitive enough to change these results. Publication bias was present only in the analysis of the sperm concentration and progressive motility. No significant difference was found for the semen volume (SMD 0.313; 95% CI -0.242 to 0.868; I2=89.7%). Conclusions: This study provides a high level of evidence in favor of a positive effect of VR to improve conventional semen parameters in infertile men with clinical varicocele. To the best of our knowledge, this is the first SRMA to compare changes in conventional semen parameters after VR with changes in parameters of a control group over the same period. This is in contrast to other SRMAs which have compared semen parameters before and after VR, without reference to a control group. Our findings strengthen the available evidence and have a potential to upgrade professional societies’ practice recommendations favoring VR to improve conventional semen parameters in infertile men.
dc.identifier.citationAgarwal, A., Cannarella, R., Saleh, R., Boitrelle, F., Gül, M., Toprak, T. ... Shah, R. (2023). Impact of varicocele repair on semen parameters in infertile men: A systematic review and meta-analysis. World Journal of Men's Health, 41(2), 289-310. https://dx.doi.org/10.5534/wjmh.220142
dc.identifier.doi10.5534/wjmh.220142
dc.identifier.endpage310
dc.identifier.issn2287-4208
dc.identifier.issn2287-4690
dc.identifier.issue2
dc.identifier.pmid36326166
dc.identifier.scopus2-s2.0-85147017767
dc.identifier.scopusqualityQ1
dc.identifier.startpage289
dc.identifier.urihttps://dx.doi.org/10.5534/wjmh.220142
dc.identifier.urihttps://hdl.handle.net/20.500.12511/10434
dc.identifier.volume41
dc.identifier.wos000892231200001en_US
dc.identifier.wosqualityQ1
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.institutionauthorÇalık, Gökhan
dc.institutionauthorde la Rosette, Jean J. M. C. H.
dc.language.isoen
dc.publisherKorean Society for Sexual Medicine and Andrology
dc.relation.ispartofWorld Journal of Men's Healthen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsAttribution-NonCommercial 4.0 International*
dc.rightsinfo:eu-repo/semantics/openAccess
dc.rights.urihttps://creativecommons.org/licenses/by-nc/4.0/*
dc.subjectMale Infertility
dc.subjectSemen
dc.subjectVaricocele
dc.titleImpact of varicocele repair on semen parameters in infertile men: A systematic review and meta-analysis
dc.typeArticle

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