A critical appraisal on the role of varicocelectomy in male infertility, "Beyond the Abstract," by Ricardo Miyaoka, MD and Sandro Esteves, MD

BERKELEY, CA (UroToday.com) - Although it has been decades since varicocele was first identified as having a negative impact on male fertility potential, many unanswered questions still remain, among them:  'why doesn't every patient with subnormal semen parameters show improvement after varicocele repair'? and 'which non-obstructive azoospermic patients with a concomitant diagnosis of varicocele would benefit from surgical correction'?

Medical decisions regarding varicocele repair must rely on accurate diagnosis, which in turn depends on solid pathological concepts and knowledge of the proper available diagnostic tools. In this field, DNA sperm fragmentation has gained increasing importance and tends to routinely become part of evaluation of the infertile male. DNA fragmentation is an indirect marker of oxidative stress, and recent evidence supports a strong association of oxidative stress in the pathophysiology of varicocele-related infertility. But above all, decisions on ideal treatment strategy must take into consideration not only the varicocele per se, but the infertile couple’s context which is defined by maternal age, couple’s willingness to cope with a more prolonged treatment, financial burden, etc.

Written by:
Ricardo Miyaoka, MD and Sandro Esteves, MD as part of Beyond the Abstract on UroToday.com. This initiative offers a method of publishing for the professional urology community. Authors are given an opportunity to expand on the circumstances, limitations etc... of their research by referencing the published abstract.

ANDROFERT—Center for Male Reproduction, Av. Dr. Heitor Penteado 1464, Campinas 13075-460, São Paulo, Brazil

A critical appraisal on the role of varicocelectomy in male infertility - Abstract

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