The Correlation between Varicocele, Sperm Parameters and Embryo Quality of ICSI Outcome in Infertile Men

Varicocele is among the most common identifiable abnormality found in men evaluated for infertility.  Despite the long history associated with varicoceles, there remains much controversy regarding their diagnosis and management. The aim of this study was to determine association between varicocele, sperm parameters, and embryo quality of ICSI outcome in infertile men.

  Fifty individuals with varicocele for Intracytoplasmic sperm injection (ICSI) treatment were included in this study. The control group included healthy men without varicoceles (n=50). Semen samples were analyzed according to the World Health Organization (WHO) criteria. Hormonal analysis of serum LH, FSH, and testosterone were measured. Sperm DNA fragmentation was assessed by SCD (Halo sperm), and then ICSI fertilization rate, percentage of high- quality embryos and chemical pregnancy rate were measured.

In semen analyses, the total sperm count, total motile sperm and normal sperm morphology were significantly lower in patients with varicocele. Also, the DNA fragmentation was significantly higher in patients with varicocele than patients in the control group (p<0.001). The level of reproductive hormones was different in varicocele and control groups (p<0.05). Fertilization rate and embryo quality were significantly lower in individuals with varicocele, when compared to men without varicocele (p<0.05). The significant negative correlation between DNA fragmentation, fertilization rate, and embryo quality were observed (p<0.05).

The effect of varicocele on male infertility may be attributed to a decrease in sperm quality as well as an increase in DNA fragmentation, which leads to reduced embryo quality in patients with varicocele.