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Purpose <p>Varicocele is a recognized male factor of infertility. Surgical/microsurgical correction represents a therapeutical option to improve fertility outcomes but predictive parameters for the identification who can actually benefit from varicocele correction are under investigated. Here we aimed to identify baseline predictors of semen outcome improvement after varicocele treatment by scleroembolization approach.</p> Methods <p>85 patients receiving varicocele treatment by anterograde scleroembolization (ASE, <i>N</i> = 42) or retrograde scleroembolization (RSE, <i>N</i> = 43) were retrospectively recruited. Basal and 6-months follow-up evaluation of semen, hormonal and ultrasound parameters (US) were performed to address the respective effect of varicocele treatment. In addition, basal parameters were assessed as clinical outcome predictors.</p> Results <p>Varicocele grade reduction was observed in more than 90% of patients (<i>P</i> &lt; 0.001). Compared to basal, significant increase of sperm concentration (10.0 ± 9.2 × 10<sup>6</sup>cells/mL vs. 23.4 ± 26.9 × 10<sup>6</sup>cells/mL; <i>P</i> &lt; 0.001), total sperm count (TSC 39.0 ± 54.5 × 10<sup>6</sup>cells vs. 70.3 ± 90.6 × 10<sup>6</sup>cells, <i>P</i> &lt; 0.001) and total motile sperm count (TMS, 9.8 ± 12.8 × 10<sup>6</sup>cells vs. 36.7 ± 58.1 × 10<sup>6</sup>cells, <i>P</i> &lt; 0.001), was observed, with no differences between RSE or ASE. All US parameters were also improved (all <i>P</i> &lt; 0.001). Logistic regression analysis of basal semen and ultrasound parameters showed that basal sperm motility and left testis-mean transit time (L-MTT) were associated with TSC and TMS doubling at follow-up. However, Receiver Operating Characteristic curve analysis showed that only basal L-MTT basal sperm was consistently associated with TSC and TMS doubling at follow-up (respectively: AUC = 0.834, CI: 0.747–0.921 and AUC = 0.805, CI: 0.708–0.901; both <i>P</i> &lt; 0.001).</p> Conclusion <p>Baseline sperm count and US parameters represent useful clinical descriptors to address those subjects eligible for varicocele correction.</p>

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Predictive parameters of semen outcome improvement after varicocele treatment by scleroembolization: a retrospective study

  • 期刊论文

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  • 发表日期：

    2026年4月29日

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  • Luca De Toni,
  • Giordana Ferraioli,
  • Matteo Todisco,
  • Sara Congiu,
  • Pierfrancesco Palego,
  • Andrea Graziani,
  • Nicola Caretta,
  • Giuseppe Grande,
  • Giorgio De Conti,
  • Massimo Lafrate,
  • Fabrizio Dal Moro,
  • Alberto Ferlin,
  • Andrea Garolla

摘要

Purpose

Varicocele is a recognized male factor of infertility. Surgical/microsurgical correction represents a therapeutical option to improve fertility outcomes but predictive parameters for the identification who can actually benefit from varicocele correction are under investigated. Here we aimed to identify baseline predictors of semen outcome improvement after varicocele treatment by scleroembolization approach.

Methods

85 patients receiving varicocele treatment by anterograde scleroembolization (ASE, N = 42) or retrograde scleroembolization (RSE, N = 43) were retrospectively recruited. Basal and 6-months follow-up evaluation of semen, hormonal and ultrasound parameters (US) were performed to address the respective effect of varicocele treatment. In addition, basal parameters were assessed as clinical outcome predictors.

Results

Varicocele grade reduction was observed in more than 90% of patients (P < 0.001). Compared to basal, significant increase of sperm concentration (10.0 ± 9.2 × 106cells/mL vs. 23.4 ± 26.9 × 106cells/mL; P < 0.001), total sperm count (TSC 39.0 ± 54.5 × 106cells vs. 70.3 ± 90.6 × 106cells, P < 0.001) and total motile sperm count (TMS, 9.8 ± 12.8 × 106cells vs. 36.7 ± 58.1 × 106cells, P < 0.001), was observed, with no differences between RSE or ASE. All US parameters were also improved (all P < 0.001). Logistic regression analysis of basal semen and ultrasound parameters showed that basal sperm motility and left testis-mean transit time (L-MTT) were associated with TSC and TMS doubling at follow-up. However, Receiver Operating Characteristic curve analysis showed that only basal L-MTT basal sperm was consistently associated with TSC and TMS doubling at follow-up (respectively: AUC = 0.834, CI: 0.747–0.921 and AUC = 0.805, CI: 0.708–0.901; both P < 0.001).

Conclusion

Baseline sperm count and US parameters represent useful clinical descriptors to address those subjects eligible for varicocele correction.