INVITED REVIEW
Year : 2016  |  Volume : 18  |  Issue : 2  |  Page : 254-258

Outcome of assisted reproductive technology in men with treated and untreated varicocele: systematic review and meta-analysis


1 ANDROFERT, Center for Male Reproduction, Av. Dr. Heitor Penteado 1464, Campinas, SP 13075-460, Brazil
2 ORIGEN, Center for Reproductive Medicine, Rio de Janeiro, Av. Rodolfo de Amoedo 140, Rio de Janeiro, RJ 22620-330, Brazil
3 American Center for Reproductive Medicine, 10681 Carnegie Avenue, X-11, Cleveland, OH 44195, USA

Correspondence Address:
Dr. Sandro C Esteves
ANDROFERT, Center for Male Reproduction, Av. Dr. Heitor Penteado 1464, Campinas, SP 13075-460
Brazil
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1008-682X.163269

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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, I2 = 25%) and live birth rates (OR = 2.17, 95% CI: 1.55-3.06, I2 = 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.


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