Urology. 2023 Sep 11:S0090-4295(23)00783-5. doi: 10.1016/j.urology.2023.08.033. Online ahead of print.
OBJECTIVE: To study whether varicocele repair would improve sperm capacitation and probability of generating a pregnancy.
METHODS: Data were collected prospectively of 40 consecutive adult men who presented with infertility confirmed by semen analysis and found to have a varicocele on exam or ultrasound who underwent unilateral or bilateral subinguinal microscopic varicocelectomy. We recorded pre and post-operative SA, Cap-Score, and PGP with a 3-month follow up. Values were compared using paired t-test and Wilcox rank-sum test.
RESULTS: Results showed a 17.4% relative increase in Cap-Score (23% to 27% capacitation), 25% relative increase in probability of generating a pregnancy (PGP) (24% to 30%), as well as statistically significant improvements in sperm concentration, motility, and total sperm count postoperatively.
CONCLUSION: This study confirms that microsurgical varicocelectomy significantly improves sperm capacitation ability and improves the expected probability of generating a pregnancy within three rounds of intrauterine insemination (IUI). The improvement in sperm capacitation ability may help explain how varicocele repair may improve the chance of pregnancy, regardless of standard semen parameter improvements.