The Effect of Varicocelectomy on Oxidative Stress and Sperm Dna Fragmentation in Infertile Males: Results from A Prospective and Controlled Study

Introduction: While male infertility is a cause of concern and treatment of varicocele is a clinical challenge, Oxidative Stress (OS) and related Sperm DNA Fragmentation (SDF) have been identified as significant causes of male infertility in men with varicocele.Although there is no direct evidence for improved pregnancy rates, varicocelectomy might reduce OS.Here, we aim to explore the role of varicocele repair as a means of reducing SDF and improving fertility.Materials and Methods: Sixty infertile males (median age 35; IQR 27-45) with varicocele demonstrated by clinical and ultrasound examination were enrolled in this single centre study from November 2022 to January 2023.Forty patients were included in an intervention group and 20 in a control group of healthy young men.All patients in the intervention group underwent varicocelectomy.SDF levels were examined in semen from all patients before and 3 months after varicocele repair.The main outcome measures were reduction of SDF level after varicocele repair, improvement of sperm parameters, and pregnancy rate. Results:The difference in SDF values in the intervention group before and after varicocele repair was 25% (p=0.01).Varicocele repair was associated with a higher pregnancy rate in the treatment group compared to controls (p=0.03). Conclusions:Varicocelectomy reduced SDF levels in semen and increased pregnancy rate as compared with controls.