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

Cannarella, Rossella and Shah, Rupin and Abo-Almagd Abdel-Meguid Hamoda, Taha and Boitrelle, Florence and Saleh, Ramadan and Gul, Murat and Rambhatla, Amarnath and Kavoussi, Parviz and Toprak, Tuncay and Harraz, Ahmed M. and Ko, Edmund and Çeker, Gökhan and Durairajanayagam, Damayanthi and Alkahidi, Noora and Kuroda, Shinnosuke and Crafa, Andrea and Henkel, Ralf and Salvio, Gianmaria and Hazir, Berk and Darbandi, Mahsa and Bendayan, Marion and Darbandi, Sara and Falcone, Marco and Garrido, Nicolas and Kosgi, Raghavender and Kaiyal, Raneen Sawaid and Karna, Keshab and Ho Vinh Phuoc, Nguyen and Birowo, Ponco and Colpi, Giovanni M. and de la Rosette, Jean and Pinggera, Germar-Michael and Nguyen, Quang and Zini, Armand and Zohdy, Wael and Singh, Rajender and Saini, Pallavi and Glina, Sidney and Lin, Haocheng and Mostafa, Taymour and Rojas-Cruz, Cesar and Arafa, Mohamed and Calogero, Aldo E. and Dimitriadis, Fotios and Kothari, Priyank and Karthikeyan, Vilvapathy Senguttuvan and Okada, Keisuke and Chiba, Koji and Kadıoglu, Ates and Altay, Baris and Turunc, Tahsin and Zilaitiene, Birute and Gokalp, Fatih and Adamyan, Aram and Katz, Darren and Chung, Eric and Mierzwa, Tiago Cesar and Zylbersztejn, Daniel Suslik and Paul, Gustavo Marquesine and Sofikitis, Nikolaos and Sokolakis, Ioannis and Malhotra, Vineet and Brodjonegoro, Sakti Ronggowardhana and Adriansjah, Ricky and Tsujimura, Akira and Amano, Toshiyasu and Balercia, Giancarlo and Ziouziou, Imad and Deswanto, Isaac Ardianson and Martinez, Marlon and Park, Hyun Jun and Bakırcıoglu, Mustafa Emre and Ceyhan, Erman and Aydos, Kaan and Ramsay, Jonathan and Minhas, Suks and Hashimi, Manaf Al and Ghayda, Ramy Abou and Tadros, Nicholas and Sindhwani, Puneet and Ho, Christopher C.K. and Rachman, Rinaldo Indra and Pena, Marcelo Rodriguez and Motawi, Ahmad and Ponnusamy, Arun Karthik and Dipankar, Satish and Amir, Azwar and Binsaleh, Saleh and Serefoglu, Ege Can and Banthia, Ravi and Khalafalla, Kareim and Basukarno, Ari and Bac, Nguyen Hoai and Singla, Karun and Ambar, Rafael F. and Makarounis, Konstantinos and Priyadarshi, Shivam and Kusuma Duarsa, Gede Wirya and Atmoko, Widi and Jindal, Sunil and Arianto, Eko and Akhavizadegan, Hamed and Bardisi, Haitham El and Shoshany, Ohad and Busetto, Gian Maria and Moussa, Mohamad and Jamali, Mounir and Al-Marhoon, Mohamed S. and Ruzaev, Mikhail and Farsi, Hasan M.A. and Mutambirwa, Shingai and Lee, Dong Sup and Kulaksiz, Deniz and Cheng, Yu-Sheng and Bouzouita, Abderrazak and Sarikaya, Selcuk and Kandil, Hussein and Tsampoukas, Georgios and Ala’a, Farkouh and Bowa, Kasonde and Savira, Missy and Mogharabian, Nasser and Le, Tan V. and Harjanggi, Maruto and Anh, Dang Tuan and Tien Long, Tran Quang and Soebadi, Mohammad Ayodhia and Hakim, Lukman and Tanic, Marko and Ari, Umut Cagin and Parikh, Firuza R. and Calik, Gokhan and Vinod, K.V. and Dorji, Gyem and Rezano, Andri and Rajmil, Osvaldo and Ba Tien, Dung Mai and Yuan, Yiming and Lizarraga-Salas, Juan Francisco and Eze, Balantine and Ngoo, Kay Seong and Lee, Joe and Arslan, Umut and Agarwal, Ashok (2023) Does Varicocele Repair Improve Conventional Semen Parameters? A Meta-Analytic Study of Before-After Data. World Journal of Men's Health, 41 (1). pp. 92-132. ISSN 22874208

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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.

Item Type: Article
Additional Information: Library Dosen
Uncontrolled Keywords: adult; Article; comparative study; data analysis; Embase; human; male; male infertility; Medline; meta analysis; outcome assessment; postoperative period; practice guideline; preoperative period; quantitative analysis; randomized controlled trial (topic); Scopus; semen parameters; seminal plasma; sperm count; sperm viability; spermatozoon density; spermatozoon motility; systematic review; total motile sperm count; varicocele; varicocelectomy
Subjects: R Medicine > RC Internal medicine
Divisions: Faculty of Medicine, Public Health and Nursing > Public Health and Nutrition
Depositing User: Ngesti Gandini
Date Deposited: 05 Jul 2024 01:35
Last Modified: 05 Jul 2024 01:35
URI: https://ir.lib.ugm.ac.id/id/eprint/2763

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