The Effect of Varicocelectomy on Assisted Reproductive Technique Indications and Outcomes based on Kruger Strict Morphology Test: a Randomized Clinical Trial

Background: A significant percent of infertile varicocele patients remained infertile after varicocelectomy and finally most of them refer for assisted reproductive technique (ART) procedures as intra uterine insemination (IUI), in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI). In order to achieve the best results, more strict and accurate standards for assessment of sperm parameters, as Kruger standards, are required. Objective:The main goal of this study was to evaluate the efficacy of varicocelectomy onimproving selection of ARTs on the base of Kruger strict morphology test. Method: In a randomized clinical trial study, the results of sperm parameters analysis by Kruger strict morphology test were compared between a group of ۶۷ infertile operated patients and a group of ۷۱ matched no operated men in one-year duration. Results: The selection of better ART levels (IUI vs. ICSI) after varicocelectomy was higher in the operated group than controls (p <۰.۰۵). Pregnancy rates (achieving full-term pregnancy by natural cycle intercourse), after one year, were respectively ۵۳.۸۴% and ۴۲.۲۵% in the two groups of operated and non-operated (p=۰.۰۸۲). Conclusion: According to our results, varicocelectomy improves the ART level selection and also may improve pregnancy success rates (both by natural cycle intercourse and ART procedures).

Keywords:

Varicocele , Semen Analysis , Assisted reproductive techniques , Kruger strict morphology test