A Novel Immunonutritional Index for Male Infertility: The Predictive Value of the HALP Score on Varicocelectomy Outcomes

Objective Predicting the outcome of varicocele repair remains a challenge in cases of male infertility. The haemoglobin, albumin, lymphocyte and platelet (HALP) score is a novel index that reflects both systemic inflammation and immunonutritional status. This study aimed to investigate the predictive value of the preoperative HALP score on semen parameter improvement after microsurgical varicocelectomy. Materials and methods We retrospectively analysed 134 patients undergoing microsurgical subinguinal varicocelectomy. Surgical success at 6 months was defined as a >50% increase in total motile sperm count (TMSC), or a >100% increase for baseline TMSC of less than 5 million. We compared the preoperative HALP score, neutrophil‐to‐lymphocyte ratio (NLR) and systemic immune‐inflammation index (SII) between the improvement and non‐improvement groups. Multivariate logistic regression and receiver operating characteristic (ROC) curve analyses were performed to identify independent predictors of success. Results Significant improvement was achieved in 74 patients (55.2%). The median preoperative HALP score was significantly higher in the Improvement Group than in the Non‐improvement Group (79 vs. 70, p = 0.048). While NLR and SII were significant in the univariate analysis, they lost statistical significance in the multivariate model. Even after adjusting for baseline parameters, the HALP score (≥75) remained a significant predictor of semen recovery (OR: 2.63, 95% CI: 1.01–6.87; p = 0.048), alongside preoperative TMSC. ROC curve analysis revealed that the HALP score had modestly statistically significant discriminative ability, with an area under the curve (AUC) of 0.600. Conclusion The preoperative HALP score is a novel, cost‐effective and promising adjunctive biomarker for predicting improvement in semen parameters after varicocelectomy. A high HALP score indicates favourable immunonutritional reserves. Identifying patients with low HALP scores could allow for preoperative optimisation to improve surgical outcomes.