Assessment of seminal cystatin C levels in infertile men with varicocele: A preliminary study

Varicocele has been raised as a contributor to male infertility supported by the improvement of sperm parameters after varicocelectomy. Cystatin C (Cys C) has been linked to several cellular changes that are common in male infertility cases associated with varicocele such as apoptosis and autophagy. This preliminary study aimed to assess the seminal levels of Cys C in infertile oligoasthenoteratozoospermic (OAT) men associated with varicocele that have been shown to have spermatic vein vasodilation and active death pathway. Overall, 60 men were investigated being divided into two equivalent groups-infertile OAT men with varicocele who underwent varicocelectomy and healthy fertile men as a control group. These men were subjected to history taking, clinical examination, semen analysis and assessment of seminal Cys C pre and 6 months post-varicocelectomy. The results showed a significant increase of seminal Cys C in infertile OAT men with varicocele than the fertile control (55.57 +/- 25.6 ng/ml versus 10.78 +/- 1.88 ng/ml, p = .001). Seminal Cys C was a significantly decreased post-operative than its pre-operative level (34.69 +/- 14.02 versus 55.57 +/- 25.6 ng/ml, p = .01). These results show a potential role of Cys C in varicocele-induced infertility.

Automated summary

Varicocele has been linked to male infertility, and improvements in sperm parameters post-varicocelectomy support this association. Cystatin C has been associated with cellular changes common in male infertility cases related to varicocele. This preliminary study found that seminal Cys C levels were significantly higher in infertile OAT men with varicocele compared to fertile men, and decreased post-operatively, suggesting a potential role of Cys C in varicocele-induced infertility.