Youth Varicocele And Varicocele Treatment: A Meta-analysisof Semen Outcomes

Objective: To study youth who have a varicocele or are undergoing varicocele treatment, in relation to changes in semen, as measured by analysis(SA).Method: Meta-analysis of studies identified via a search of Pub Med,Medline,and Cochrane Library covering the last 20 years.Selected studies were analyzed in two separate meta-analyses:one for the effect of varicocele on semen, as measured by SA(Hypothesis #1),the other for the effect of treatment on semen,as measured by SA(hypothesis #2).A random-effect model was used to calculate weighted mean differrece of semen outcomes.Heterogeneity was calculated.Bias was assessed with funnel plots.Result(s):The initial literature search returned 1180 potentially relevant articles.For hypothesis 1:eight studies with a total of 165 varicocele and 310 control. Sperm density and motility were significantly decreased when associated with a varicocele, with a Std.Mean Difference of 0.79,95%CI(0.30-1.29) and 0.62, 95%CI(0.18-1.05) respectively. Another 6 studies with 160 treated and 160 untreated subjects were analyzesd for hypothesis #2.Sperm density and motility were significantly improvd following treatment, with a Std.Mean Difference of 1.4, 95%CI(0.30-2.51) and 1.47,95% CI(0.14-2.79),respectively。Conclusion(s):The presense of varicocele in youth appears to negatively affect sperm density and motility.Treatment appears to result in moderate improvement of sperm density and mild improvement in sperm motility.