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Clinical significance of subclinical varicocelectomy in male infertility: systematic review and meta‐analysis
Author(s) -
Kim H. J.,
Seo J. T.,
Kim K. J.,
Ahn H.,
Jeong J. Y.,
Kim J. H.,
Song S. H.,
Jung J. H.
Publication year - 2016
Publication title -
andrologia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.633
H-Index - 59
eISSN - 1439-0272
pISSN - 0303-4569
DOI - 10.1111/and.12495
Subject(s) - varicocele , subclinical infection , medicine , meta analysis , infertility , pregnancy rate , pregnancy , male infertility , semen analysis , semen , odds ratio , gynecology , obstetrics , andrology , biology , genetics
Summary Recent meta‐analysis by the Cochrane collaboration concluded that treatment of varicocele may improve an infertile couple's chance of pregnancy. However, there has been no consensus on the management of subclinical varicocele. Therefore, we determine the impact of varicocele treatment on semen parameters and pregnancy rate in men with subclinical varicocele. The randomised controlled trials that assessed the presence and/or treatment of subclinical varicocele were included for systematic review and meta‐analysis. Random effect model was used to calculate the weighted mean difference of semen parameters and odds ratio of pregnancy rates. Seven trials with 548 participants, 276 in subclinical varicocelectomy and 272 in no‐treatment or clomiphene citrate subjects, were included. Although there was also no statistically significant difference in pregnancy rate ( OR 1.29, 95% CI 0.99–1.67), surgical treatment resulted in statistically significant improvements on forward progressive sperm motility ( MD 3.94, 95% CI 1.24–6.65). However, the evidence is not enough to allow final conclusions because the quality of included studies is very low and further research is needed.