An Observation Of Surgical Treatment In Infertile Varicocele Patients

Objective: To examine the semen quality and the sperm morphology in infertile men with varicocele before and after ligation. To follow up the patients'pregnancy rate. To comprehend the effect of surgical treatment.Method: A comparison of their spermous qualities both before and after the ligations had been made in the 30 cases of infertile patients who are diagnosed as VC by chief complaint, symptoms, or ultrasonic scrotum scan, including 27 patients on the left side and the other on the both sides.Of the 30 patients there are 5 ones in the mild state, 17 ones in the moderate state and 8 ones in the severe state. The average age of the patients is 29.6±5.6 year-old whose age are from 25-38 years old. They all have normal sex life but undergo history of infertile over 12 months. An 18-month follow-up had been done to the 21 cases of patients with infertility VC. Except for 8 patients having the ability of fertile because of ligation we analyze the different stages of change in semen quality and sperm morphology of the left 13 cases of such patients who joined the 18-month follow-up. Statictical analysis: As all measured and calculated data described were presented as mean values with standard deviations (±s). Software SPSS 15.0 was applied for analyzing the data. Student t tests for paired samples were performed as appropriate to compare intergroup differences. A value of P<0.05 was considered to be statistically significant.Results: Both semen quality and sperm morphology were remarkably improved in the 30 infertile patients after varicoceletomy(P<0.05). The two indexes were back to normal in 10 cases, semen situation improved in different degrees to 17 cases, three cases invalid. There is respectively significance between the presurgery and postsurgery of the ratio of normal sperm(P<0.05), the significance are also shown at the amorphous head sperm and some other abnormal morphology sperm. The pregnancy rate (43.8%) of the 21 cases who joined the long-term follow-up was higher than the natural pregnancy rate in infertile varicocele patients in literature, of whom 1 patient was pregnant after 6 months from surgery, 7 ones after 6-12 months, and another one was pregnant after 12-18 months. And 13 cases of them were no longer significantly further restoration in sperm morphology during 6-12 months after the operation (P>0.05).Conclusion: The controlled trials of high spermatic veins can improve the semen quality and enhance the fertility of the infertile patients with varicocele. According to our study and research in the 30 infertile patients after varicoceletomy, the semen quality and sperm morphology were back to normal in 10 cases, semen situation improved in different degrees to 17 cases, three cases invalid. The pregnancy rate of the 21 cases who joined the long-term follow-up was 43.8% during the first 18 months after operation,which is higher than the natural pregnancy rate in infertile varicocele patients in literature. We found that the benefits of these patients'semen has been show in the first six months. Do suggest the infertile couple to accept the further detection.