Feasibility of loupe assisted subinguinal varicocelectomy in treatment of male infertility

Objectives: To study the impact of loupe assisted subinguinal varicocelectomy on semen quality, serum testosterone level, and spontaneous pregnancy rate. Methods: The data were prospectively collected for 102 infertile men with clinical varicocele. The preoperative values of semen analysis parameters and serum testosterone level were compared with postoperative values at 6 months. Spontaneous pregnancy was assessed at 6 months. Results: The mean age of patients was 31.56 +/- 4.31 years. Primary infertility was reported in 86 patients, while 16 had secondary infertility. Bilateral varicocele was seen in 79 patients while 23 had a unilateral varicocele. The total sperm concentration (x10(6)/ml) before and after varicocelectomy was 12.82 +/- 3.91 and 20.06 +/- 2.13 respectively (P<.0001). The total sperm motility (%) before and after varicocelectomy was 37.67 +/- 7.23 and 55.46 +/- 4.51 respectively (P<.0001). The sperm morphology (Kruger/Strict morphology criteria, %) before and after varicocelectomy was 3.11 +/- 0.80 and 3.70 +/- 0.78 respectively (P<.0001). The serum testosterone level (ng/dl) before and after varicocelectomy was 323.90 +/- 67.81 and 396.74 +/- 40.88 respectively (p<0.0001). The Spontaneous pregnancy rate in couples with primary and secondary infertility was 18.60% and 31.25% respectively. The difference in their rates was not significant (P = .251). The overall spontaneous pregnancy rate was 20.5%. Conclusion: Loupe-assisted sub-inguinal varicocelectomy is a safe and effective modality for treating infertile men, particularly when provision for microscopic surgery is unavailable. However, only large size comparative studies or multi-centric trials can confirm this. (C) 2022 AEU. Published by Elsevier Espana, S.L.U. All rights reserved.

Automated summary

Loupe-assisted subinguinal varicocelectomy has a positive impact on semen quality, serum testosterone level, and spontaneous pregnancy rate.