The effect of varicocelectomy on intracytoplasmic sperm injection pregnancy success in patients with severe oligospermia and varicocele

OBJECTIVES: There is still controversy about the necessity of varicocelectomy in infertile men with severe oligospermia if varicocelectomy is additionally available and Intracytoplasmic Sperm Injection (ICSI) is planned. This study will investigate the effect of varicocelectomy on ICSI success in varicocele patients with severe oligospermia. MATERIAL and METHODS: The data of 60 patients with varicocelectomy before ICSI (Group 1) and 32 patients without varicocelectomy before ICSI (Group 2) were compared. Patient and partner age, hormone levels and sperm parameters from demographic data, hormone levels and sperm parameters from laboratory tests, and scrotal Doppler ultrasonography results radiologically were compared. After ICSI, clinical pregnancy rates, miscarriage rates and live birth rates were evaluated. RESULTS: There was a significant increase in sperm count and motility in Group 1 patients after varicocelectomy surgery. When the preoperative and postoperative sperm parameters of the patients in Group 1 were compared with those in Group 2, it was found that there was no difference before the varicocelectomy , while only sperm count was statistically affected after the surgery. Clinical pregnancy was observed in 44 patients (73.3%) in Group 1 and 21 patients (65.6%) in Group 2 and there was no statistical difference between the groups (p: 0.321). Miscarriage was observed in 11 patients (25%) in Group 1 and 7 patients (33.3%) in Group 2 (p: 0.128). Live birth was observed in 33 patients (55%) in Group 1 and 14 patients (43.7%) in Group 2 and was statistically higher in Group 1 (p: 0.026). CONCLUSION: In varicocelectomy patients with severe oligospermia, varicocelectomy before ICSI does not affect clinical pregnancy and miscarriage rates, but causes an increase in live birth rates. Keywords: intracytoplasmic sperm injection, varicocelectomy, severe oligospermia, pregnancy rate