Determination of semen parameters healing time and predictive factors after varicocelectomy

Aim: It is aimed to determine the healing time of the semen parameters and predictive factors in patients who underwent microscopic inguinal varicocelectomy between 2005 and 2016 at Istanbul Faculty of Medicine. Material and Method: Time-related changes, clinical parameters and pregnancy rates of 175 patients were analyzed retrospectively for evaluation of healing time of semen parameters and predictive factors after microscopic varicocelectomy. Results: There was no significant increase in sperm concentration and sperm morphology after varicocelectomy. Compared with preoperative values in sperm motility, significant improvement was observed at 6, 9 and 12 months postoperatively. However, there was no significant improvement in sperm motility after 6 months. When the total number of motile sperm (TMSS) was compared with preoperative values, a statistically significant increase was detected at 3, 6, 9 and 12th months postoperatively. However, when 6, 9, and 12th months were compared with 3rd month, there was no significant difference at 6 and 9th months, a significant increase was detected at 12th month. According to the initial TMSS values, when the patients were divided into three groups of <5 million, 5-9 million, and> 9 million, no significant improvement was detected in the <5 million group after 3 months. Significant improvement was observed at 6 months in the initial TMSS value 5-9 million group, but no significant improvement was detected after 6 months. Significant improvement was observed in TMSS at the 12th month in the initial value> 9 million group. The age at the time of operation, varicocele grade, pre operative FSH and testosterone, the largest ven diameter detected in the ultrasound and number of veins ligated during microsurgical varicocelectomy were not predictive of the recovery time in the semen parameters. Spontaneous pregnancy developed in 32% of the couples. Conclusions: When patients are grouped according to baseline semen parameters, recovery may occur at different times following varicocele treatment. For possible varicocelectomy candidates, treatment strategies can be determined by considering time-dependent changes in semen parameters.