Are varicoceles associated with increased deoxyribonucleic acid fragmentation?

Objective: To perform a literature search on the association between varicocele and sperm DNA fragmentation. Design: Systematic review. Patient(s): Men with a varicocele and infertility. Intervention(s): Varicocele repair. Main Outcome Measure(s): Does the presence of a varicocele increase seminal oxidative stress and sperm DNA fragmentation? Result(s): In men with a varicocele increased levels of reactive oxygen species and sperm DNA damage can be found. This is probably related to defective spermatogenesis in these patients. Seminal oxidative stress is believed to be the source of sperm DNA damage. Patients with a varicocele and oligospermia may also have a diminished seminal antioxidant capacity. After varicocele repair sperm DNA fragmentation decreases. Conclusion(s): Varicocele is associated with sperm DNA damage, and this sperm pathology may be secondary to varicocele-mediated oxidative stress. The beneficial effect of varicocelectomy on sperm DNA damage further supports the premise that varicocele may impair sperm DNA integrity. (Fertil Steril (R) 2011; 96:1283-7. (c) 2011 by American Society for Reproductive Medicine.)