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| Home > Articles > Published articles > Effects of Varicocele Repair on Sperm DNA Fragmentation and Seminal Malondialdehyde Levels in Infertile Men with Clinical Varicocele : |
| Home > Articles > Published articles > Effects of Varicocele Repair on Sperm DNA Fragmentation and Seminal Malondialdehyde Levels in Infertile Men with Clinical Varicocele : |
(Global Andrology Forum, Moreland Hills, OH) (Lilavati Hospital) (Sohag University) (Paris Saclay University) (Minia University) (Central Drug Research Institute (Lucknow)) (Polytechnic University of Marche) (University of Health Sciences (Istanbul)) (University of Turin) (Selçuk University School of Medicine) (Aristotle University of Thessaloniki) (Vattikuti Urology Institute) (University of Catania) (Loma Linda University Health) (McGill University) (Austin Fertility & Reproductive Medicine/Westlake IVF) (Pham Ngoc Thach University of Medicine) (Fakih IVF Fertility Center) (Case Western Reserve University) (Universitas Indonesia) (Algiers University) (Baskent University) (The Fourth Military Medical University) (SCM Clinic and Hospital (New Delhi)) (Universiti Teknologi MARA) (Istanbul Medipol University) (Siloam Sriwijaya Hospital) (Istanbul Medipol University) (University of Mersin School of Medicine) (Medical University Innsbruck) (Global Andrology Forum) (Institut de Recerca Sant Pau) (Cairo University) (Universitas Indonesia) (Mansoura University) (Pham Ngoc Thach University of Medicine) (Istanbul Medipol Mega University Hospital) (Universitas Airlangga) (Next Fertility GynePro) (Research Centre for Medical Genetics (Moscou)) (6th October University) (Central Drug Research Institute (Lucknow)) (Cleveland Clinic)| Date: | 2024 |
| Abstract: | Varicoceles can be a source of elevated seminal oxidative stress (OS) and sperm DNA fragmentation (SDF). However, it remains unclear whether varicocele repair (VR) could reduce these parameters. This systematic review and meta-analysis (SRMA) aims to investigate the impact of VR on SDF and seminal malondialdehyde (MDA). A literature search was performed in Scopus, PubMed, Ovid, Embase, and Cochrane databases. This SRMA included randomized controlled trials and observational studies reporting the pre- and postoperative levels of SDF and seminal OS in infertile men with clinical varicocele that underwent VR. Subgroup analyses included techniques of VR and SDF testing. The effect size was expressed as standardized mean difference (SMD). Out of 1,632 abstracts assessed for eligibility, 29 studies with 1,491 infertile men were included. The analysis showed a significant reduction in SDF after VR, compared to preoperative values (SMD −1. 125, 95% confidence interval [CI] −1. 410, −0. 840; p<0. 0001) with high inter-study heterogeneity (I 2 =90. 965%). Reduction in SDF was evident with microsurgical technique and non-microsurgical inguinal approaches (SMD −1. 014, 95% CI −1. 263, −0. 765; p<0. 0001, and SMD −1. 495, 95% CI −2. 116, −0. 873; p<0. 0001), respectively. Reduction in SDF was significant irrespective of testing was done by sperm chromatin dispersion (SMD −2. 197, 95% CI −3. 187, −1. 207; p<0. 0001), sperm chromatin structure assay (SMD −0. 857, 95% CI −1. 156, −0. 559; p<0. 0001) or TUNEL (SMD −1. 599, 95% CI −2. 478, −0. 719; p<0. 0001). A significant decrease in seminal MDA levels was observed following VR (SMD −2. 450, 95% CI −3. 903 to −0. 997, p=0. 001) with high inter-study heterogeneity (I 2 =93. 7%). Using pre- and post-intervention data, this SRMA indicates a significant reduction in SDF and seminal MDA levels in infertile men with clinical varicocele treated with VR. These findings may have important implications for the future management of this selected group of infertile patients. |
| Rights: | Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.  |
| Language: | Anglès |
| Document: | Article ; recerca ; Versió publicada |
| Subject: | DNA fragmentation ; Infertility, male ; Malondialdehyde ; Varicocele |
| Published in: | The world journal of men's health, Vol. 42 (january 2024) , p. 321-337, ISSN 2287-4690 |
