Effect of varicocelectomy on sperm creatine kinase, HspA2 chaperone protein (creatine kinase-M type), LDH, LDH-X, and lipid peroxidation product levels in infertile men with varicocele

Objectives. To determine the total sperm creatine kinase, HspA2 chaperone protein (creatine kinase-M isoform), lactate dehydrogenase (LDH), LDH-X activities, and lipid peroxidation product (malondialdehyde [MDA]) levels in infertile men with varicocele and to examine the possible effect of varicocelectomy on these parameters. Methods. Eighty-one men were enrolled in this study. The study population consisted of a control group (n = 25) and a varicocele group (n = 56). Of the 56 patients with varicocele, 26 underwent microsurgical subinguinal varicocelectomy at our institution between July 2002 and July 2003. The standard semen parameters (sperm concentration and motility and Kruger morphology) and total sperm creatine kinase, HspA2, LDH, and LDHA activities, and MDA levels were assessed in the control and varicocele groups. The differences were compared between the two groups. The same parameters were repeated at 6 months postoperatively in the varicocelectomy group and the preoperative and postoperative results were compared. Results. The sperm concentration was significantly lower in the varicocele group than in the control group (P = 0.01). The mean sperm HspA2 activities were significantly lower and the LDH activities and MDA levels were significantly greater in the varicocele group than in the control group (P = 0.005 and P = 0.001, P <0.001, respectively). No statistically significant difference was found in the semen parameters in the varicocelectomy group preoperatively and postoperatively. Sperm HspA2 activities increased significantly after varicocelectomy compared with preoperatively (P <0.001). Conclusions. Our data suggest that sperm HspA2 activities are lower and LDH activities and MDA levels are greater in infertile men with varicocele. These data also suggest that varicocelectomy increases HspA2 activities in these patients.