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The effect of microsurgical varicocelectomy on serum follicle stimulating hormone, testosterone and free testosterone levels in infertile men with varicocele
Author(s) -
Selahíttín Çayan,
Ateş Kadıoğlu,
İsrafil Orhan,
Engin Kandıralı,
Ahmet Tefekli̇,
S Tellaloğlu
Publication year - 1999
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1046/j.1464-410x.1999.00353.x
Subject(s) - varicocele , testosterone (patch) , hormone , medicine , follicle stimulating hormone , sperm motility , sperm , endocrinology , male infertility , infertility , andrology , urology , biology , luteinizing hormone , pregnancy , genetics
Objectives To analyse the effects of varicocelectomy on serum follicle‐stimulating hormone (FSH), testosterone and free testosterone levels, and to investigate the interrelationships between seminal and hormonal variables. Patients and methods The records were retrospectively evaluated for 78 infertile patients who underwent microsurgical inguinal varicocelectomy, with documented serum FSH, testosterone, free testosterone levels, sperm concentration and sperm motility before and after surgery. Left and bilateral varicoceles were detected in 40 and 38 patients, respectively. In addition, serum hormonal values of 10 fertile men in whom physical examinations and Doppler ultrasonography revealed no evidence of varicocele were recorded and used as a control group. Results The mean (sd) serum FSH levels of all patients decreased from 15.21 (3.34) before surgery to 10.82 (2.93) mIU/mL afterward ( P =0.01), and serum testosterone levels increased from 5.63 (1.40) to 8.37 (2.2) ng/mL ( P =0.01), whereas free testosterone levels increased from 23.13 (3.19) to 32.83 (4.37) pg/mL ( P <0.001). In contrast to the significant difference in sperm motility before and after surgery of all patients ( P <0.01), the difference in sperm count was insignificant ( P >0.05). Thirty‐six patients with high serum FSH levels before surgery had significantly lower levels afterward ( P =0.001). In this group, the sperm concentration and motility also increased, from 17.66 (4.35) to 20.76 (4.37) million/mL ( P =0.05) and from 30.9 (4.4)% to 37.5 (4.34)%, respectively ( P =0.01). In the remaining 42 patients who had normal preoperative serum FSH levels, there was a slight decrease after surgery ( P =0.02). Their sperm concentration increased slightly ( P =0.04), and motility also increased ( P =0.001). Sixty patients had a significantly higher testosterone level after surgery; in this group the sperm concentration and motility increased ( P =0.01). Conclusion Varicocelectomy promotes Sertoli and Leydig cell function. The significant increase in serum free testosterone level results in a significant improvement in sperm concentration and motility.