Does Varicocele Repair Improve Conventional Semen Parameters? A Meta-Analytic Study of Before-After Data

Global Andrology Forum

doi:10.5534/wjmh.230034

Does Varicocele Repair Improve Conventional Semen Parameters? A Meta-Analytic Study of Before-After Data

Global Andrology Forum

Surgery

Research output: Contribution to journal › Article › peer-review

1 Citation (Scopus)

Abstract

PURPOSE: The purpose of this meta-analysis is to study the impact of varicocele repair in the largest cohort of infertile males with clinical varicocele by including all available studies, with no language restrictions, comparing intra-person conventional semen parameters before and after the repair of varicoceles.

MATERIALS AND METHODS: The meta-analysis was performed according to PRISMA-P and MOOSE guidelines. A systematic search was performed in Scopus, PubMed, Cochrane, and Embase databases. Eligible studies were selected according to the PICOS model (Population: infertile male patients with clinical varicocele; Intervention: varicocele repair; Comparison: intra-person before-after varicocele repair; Outcome: conventional semen parameters; Study type: randomized controlled trials [RCTs], observational and case-control studies).

RESULTS: Out of 1,632 screened abstracts, 351 articles (23 RCTs, 292 observational, and 36 case-control studies) were included in the quantitative analysis. The before-and-after analysis showed significant improvements in all semen parameters after varicocele repair (except sperm vitality); semen volume: standardized mean difference (SMD) 0.203, 95% CI: 0.129-0.278; p<0.001; I²=83.62%, Egger's p=0.3329; sperm concentration: SMD 1.590, 95% CI: 1.474-1.706; p<0.001; I²=97.86%, Egger's p<0.0001; total sperm count: SMD 1.824, 95% CI: 1.526-2.121; p<0.001; I²=97.88%, Egger's p=0.0063; total motile sperm count: SMD 1.643, 95% CI: 1.318-1.968; p<0.001; I²=98.65%, Egger's p=0.0003; progressive sperm motility: SMD 1.845, 95% CI: 1.537%-2.153%; p<0.001; I²=98.97%, Egger's p<0.0001; total sperm motility: SMD 1.613, 95% CI 1.467%-1.759%; p<0.001; l2=97.98%, Egger's p<0.001; sperm morphology: SMD 1.066, 95% CI 0.992%-1.211%; p<0.001; I²=97.87%, Egger's p=0.1864.

CONCLUSIONS: The current meta-analysis is the largest to date using paired analysis on varicocele patients. In the current meta-analysis, almost all conventional semen parameters improved significantly following varicocele repair in infertile patients with clinical varicocele.

Original language	English
Pages (from-to)	92-132
Number of pages	41
Journal	World Journal of Men?s Health
Volume	42
Issue number	1
DOIs	https://doi.org/10.5534/wjmh.230034
Publication status	Published - Jan 1 2023

Keywords

Controlled before-after studies
Infertility, male
Meta-analysis
Varicocele

ASJC Scopus subject areas

Reproductive Medicine
Ageing
Health Policy
Public Health, Environmental and Occupational Health
Psychiatry and Mental health
Urology
Pharmacology (medical)

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.5534/wjmh.230034

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@article{0b94f1718f2f44fcbce6f093939303e9,

title = "Does Varicocele Repair Improve Conventional Semen Parameters? A Meta-Analytic Study of Before-After Data",

abstract = "PURPOSE: The purpose of this meta-analysis is to study the impact of varicocele repair in the largest cohort of infertile males with clinical varicocele by including all available studies, with no language restrictions, comparing intra-person conventional semen parameters before and after the repair of varicoceles.MATERIALS AND METHODS: The meta-analysis was performed according to PRISMA-P and MOOSE guidelines. A systematic search was performed in Scopus, PubMed, Cochrane, and Embase databases. Eligible studies were selected according to the PICOS model (Population: infertile male patients with clinical varicocele; Intervention: varicocele repair; Comparison: intra-person before-after varicocele repair; Outcome: conventional semen parameters; Study type: randomized controlled trials [RCTs], observational and case-control studies).RESULTS: Out of 1,632 screened abstracts, 351 articles (23 RCTs, 292 observational, and 36 case-control studies) were included in the quantitative analysis. The before-and-after analysis showed significant improvements in all semen parameters after varicocele repair (except sperm vitality); semen volume: standardized mean difference (SMD) 0.203, 95% CI: 0.129-0.278; p<0.001; I²=83.62%, Egger's p=0.3329; sperm concentration: SMD 1.590, 95% CI: 1.474-1.706; p<0.001; I²=97.86%, Egger's p<0.0001; total sperm count: SMD 1.824, 95% CI: 1.526-2.121; p<0.001; I²=97.88%, Egger's p=0.0063; total motile sperm count: SMD 1.643, 95% CI: 1.318-1.968; p<0.001; I²=98.65%, Egger's p=0.0003; progressive sperm motility: SMD 1.845, 95% CI: 1.537%-2.153%; p<0.001; I²=98.97%, Egger's p<0.0001; total sperm motility: SMD 1.613, 95% CI 1.467%-1.759%; p<0.001; l2=97.98%, Egger's p<0.001; sperm morphology: SMD 1.066, 95% CI 0.992%-1.211%; p<0.001; I²=97.87%, Egger's p=0.1864.CONCLUSIONS: The current meta-analysis is the largest to date using paired analysis on varicocele patients. In the current meta-analysis, almost all conventional semen parameters improved significantly following varicocele repair in infertile patients with clinical varicocele.",

keywords = "Controlled before-after studies, Infertility, male, Meta-analysis, Varicocele",

author = "{Global Andrology Forum} and Rossella Cannarella and Rupin Shah and {Abo-Almagd Abdel-Meguid Hamoda}, Taha and Florence Boitrelle and Ramadan Saleh and Murat Gul and Amarnath Rambhatla and Parviz Kavoussi and Tuncay Toprak and Harraz, {Ahmed M.} and Edmund Ko and G{\"o}khan {\c C}eker and Damayanthi Durairajanayagam and Noora Alkahidi and Shinnosuke Kuroda and Andrea Crafa and Ralf Henkel and Gianmaria Salvio and Berk Hazir and Mahsa Darbandi and Marion Bendayan and Sara Darbandi and Marco Falcone and Nicolas Garrido and Raghavender Kosgi and Kaiyal, {Raneen Sawaid} and Keshab Karna and {Ho Vinh Phuoc}, Nguyen and Ponco Birowo and Colpi, {Giovanni M.} and {de la Rosette}, Jean and Pinggera, {Germar Michael} and Quang Nguyen and Armand Zini and Wael Zohdy and Rajender Singh and Pallavi Saini and Sidney Glina and Haocheng Lin and Taymour Mostafa and Cesar Rojas-Cruz and Mohamed Arafa and Calogero, {Aldo E.} and Fotios Dimitriadis and Priyank Kothari and Karthikeyan, {Vilvapathy Senguttuvan} and Keisuke Okada and Koji Chiba and Ates Kadıoglu and Al-Marhoon, {Mohamed S.}",

year = "2023",

month = jan,

day = "1",

doi = "10.5534/wjmh.230034",

language = "English",

volume = "42",

pages = "92--132",

journal = "World Journal of Men?s Health",

issn = "2287-4208",

publisher = "Korean Society for Sexual Medicine and Andrology",

number = "1",

}

TY - JOUR

T1 - Does Varicocele Repair Improve Conventional Semen Parameters? A Meta-Analytic Study of Before-After Data

AU - Global Andrology Forum

AU - Cannarella, Rossella

AU - Shah, Rupin

AU - Abo-Almagd Abdel-Meguid Hamoda, Taha

AU - Boitrelle, Florence

AU - Saleh, Ramadan

AU - Gul, Murat

AU - Rambhatla, Amarnath

AU - Kavoussi, Parviz

AU - Toprak, Tuncay

AU - Harraz, Ahmed M.

AU - Ko, Edmund

AU - Çeker, Gökhan

AU - Durairajanayagam, Damayanthi

AU - Alkahidi, Noora

AU - Kuroda, Shinnosuke

AU - Crafa, Andrea

AU - Henkel, Ralf

AU - Salvio, Gianmaria

AU - Hazir, Berk

AU - Darbandi, Mahsa

AU - Bendayan, Marion

AU - Darbandi, Sara

AU - Falcone, Marco

AU - Garrido, Nicolas

AU - Kosgi, Raghavender

AU - Kaiyal, Raneen Sawaid

AU - Karna, Keshab

AU - Ho Vinh Phuoc, Nguyen

AU - Birowo, Ponco

AU - Colpi, Giovanni M.

AU - de la Rosette, Jean

AU - Pinggera, Germar Michael

AU - Nguyen, Quang

AU - Zini, Armand

AU - Zohdy, Wael

AU - Singh, Rajender

AU - Saini, Pallavi

AU - Glina, Sidney

AU - Lin, Haocheng

AU - Mostafa, Taymour

AU - Rojas-Cruz, Cesar

AU - Arafa, Mohamed

AU - Calogero, Aldo E.

AU - Dimitriadis, Fotios

AU - Kothari, Priyank

AU - Karthikeyan, Vilvapathy Senguttuvan

AU - Okada, Keisuke

AU - Chiba, Koji

AU - Kadıoglu, Ates

AU - Al-Marhoon, Mohamed S.

PY - 2023/1/1

Y1 - 2023/1/1

N2 - PURPOSE: The purpose of this meta-analysis is to study the impact of varicocele repair in the largest cohort of infertile males with clinical varicocele by including all available studies, with no language restrictions, comparing intra-person conventional semen parameters before and after the repair of varicoceles.MATERIALS AND METHODS: The meta-analysis was performed according to PRISMA-P and MOOSE guidelines. A systematic search was performed in Scopus, PubMed, Cochrane, and Embase databases. Eligible studies were selected according to the PICOS model (Population: infertile male patients with clinical varicocele; Intervention: varicocele repair; Comparison: intra-person before-after varicocele repair; Outcome: conventional semen parameters; Study type: randomized controlled trials [RCTs], observational and case-control studies).RESULTS: Out of 1,632 screened abstracts, 351 articles (23 RCTs, 292 observational, and 36 case-control studies) were included in the quantitative analysis. The before-and-after analysis showed significant improvements in all semen parameters after varicocele repair (except sperm vitality); semen volume: standardized mean difference (SMD) 0.203, 95% CI: 0.129-0.278; p<0.001; I²=83.62%, Egger's p=0.3329; sperm concentration: SMD 1.590, 95% CI: 1.474-1.706; p<0.001; I²=97.86%, Egger's p<0.0001; total sperm count: SMD 1.824, 95% CI: 1.526-2.121; p<0.001; I²=97.88%, Egger's p=0.0063; total motile sperm count: SMD 1.643, 95% CI: 1.318-1.968; p<0.001; I²=98.65%, Egger's p=0.0003; progressive sperm motility: SMD 1.845, 95% CI: 1.537%-2.153%; p<0.001; I²=98.97%, Egger's p<0.0001; total sperm motility: SMD 1.613, 95% CI 1.467%-1.759%; p<0.001; l2=97.98%, Egger's p<0.001; sperm morphology: SMD 1.066, 95% CI 0.992%-1.211%; p<0.001; I²=97.87%, Egger's p=0.1864.CONCLUSIONS: The current meta-analysis is the largest to date using paired analysis on varicocele patients. In the current meta-analysis, almost all conventional semen parameters improved significantly following varicocele repair in infertile patients with clinical varicocele.

AB - PURPOSE: The purpose of this meta-analysis is to study the impact of varicocele repair in the largest cohort of infertile males with clinical varicocele by including all available studies, with no language restrictions, comparing intra-person conventional semen parameters before and after the repair of varicoceles.MATERIALS AND METHODS: The meta-analysis was performed according to PRISMA-P and MOOSE guidelines. A systematic search was performed in Scopus, PubMed, Cochrane, and Embase databases. Eligible studies were selected according to the PICOS model (Population: infertile male patients with clinical varicocele; Intervention: varicocele repair; Comparison: intra-person before-after varicocele repair; Outcome: conventional semen parameters; Study type: randomized controlled trials [RCTs], observational and case-control studies).RESULTS: Out of 1,632 screened abstracts, 351 articles (23 RCTs, 292 observational, and 36 case-control studies) were included in the quantitative analysis. The before-and-after analysis showed significant improvements in all semen parameters after varicocele repair (except sperm vitality); semen volume: standardized mean difference (SMD) 0.203, 95% CI: 0.129-0.278; p<0.001; I²=83.62%, Egger's p=0.3329; sperm concentration: SMD 1.590, 95% CI: 1.474-1.706; p<0.001; I²=97.86%, Egger's p<0.0001; total sperm count: SMD 1.824, 95% CI: 1.526-2.121; p<0.001; I²=97.88%, Egger's p=0.0063; total motile sperm count: SMD 1.643, 95% CI: 1.318-1.968; p<0.001; I²=98.65%, Egger's p=0.0003; progressive sperm motility: SMD 1.845, 95% CI: 1.537%-2.153%; p<0.001; I²=98.97%, Egger's p<0.0001; total sperm motility: SMD 1.613, 95% CI 1.467%-1.759%; p<0.001; l2=97.98%, Egger's p<0.001; sperm morphology: SMD 1.066, 95% CI 0.992%-1.211%; p<0.001; I²=97.87%, Egger's p=0.1864.CONCLUSIONS: The current meta-analysis is the largest to date using paired analysis on varicocele patients. In the current meta-analysis, almost all conventional semen parameters improved significantly following varicocele repair in infertile patients with clinical varicocele.

KW - Controlled before-after studies

KW - Infertility, male

KW - Meta-analysis

KW - Varicocele

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U2 - 10.5534/wjmh.230034

DO - 10.5534/wjmh.230034

M3 - Article

C2 - 37382284

AN - SCOPUS:85175731583

SN - 2287-4208

VL - 42

SP - 92

EP - 132

JO - World Journal of Men?s Health

JF - World Journal of Men?s Health

IS - 1

ER -

Does Varicocele Repair Improve Conventional Semen Parameters? A Meta-Analytic Study of Before-After Data

Abstract

Keywords

ASJC Scopus subject areas

UN SDGs

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