alexa Reassessing the value of varicocelectomy as a treatment for male subfertility with a new meta-analysis.
Reproductive Medicine

Reproductive Medicine

Reproductive System & Sexual Disorders: Current Research

Author(s): Marmar JL, Agarwal A, Prabakaran S, Agarwal R, Short RA,

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Abstract OBJECTIVE: To determine the efficacy of varicocelectomy as a treatment for male factor infertility by improving the chance of spontaneous pregnancy. DESIGN: Meta-analysis. SETTING: Cleveland Clinic's Glickman Urological Institute. PATIENT(S): Infertile men with abnormal results on semen analyses and a palpable varicocele. INTERVENTION(S): Surgical varicocelectomy. MAIN OUTCOME MEASURE(S): Spontaneous pregnancy outcome. RESULT(S): The odds of spontaneous pregnancy after surgical varicocelectomy, compared with no or medical treatment for palpable varicocele, were 2.87 (95\% confidence interval [CI], 1.33-6.20) with use of a random-effects model or 2.63 (95\% CI, 1.60-4.33) with use of a fixed-effects model. The number needed to treat was 5.7 (95\% CI, 4.4-9.5). CONCLUSION(S): Surgical varicocelectomy in infertile men with palpable lesions and at least one abnormal semen parameter improves the odds of spontaneous pregnancy in their female partners. Five studies were included (two randomized, three observational). All were scored for bias. Our study suggests that varicocelectomy in selected patients does indeed have beneficial effects on fertility status. This article was published in Fertil Steril and referenced in Reproductive System & Sexual Disorders: Current Research

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