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Meta-Analysis
. 2024 Nov;12(8):1642-1650.
doi: 10.1111/andr.13602. Epub 2024 Feb 12.

Is varicocoelectomy indicated in infertile men with isolated teratozoospermia? a systematic review and meta-analysis

Murat Dursun  1 , Hüseyin Beşiroğlu  2 , Reşat Aydın  1 , Turgay Kaçan  3 , Ahmet Halil Sevinç  3 , Ateş Kadıoğlu  3
Affiliations
Meta-Analysis

Is varicocoelectomy indicated in infertile men with isolated teratozoospermia? a systematic review and meta-analysis

Murat Dursun et al. Andrology. 2024 Nov.

Abstract

Background: Clinical palpable varicocoeles in conjunction with isolated teratozoospermia are rarely observed. Therefore, the effects of varicocoelectomy on sperm morphology are not clear. The aim of this meta-analysis is to compile studies that assess the effectiveness of varicocoelectomy in isolated teratozoospermia to reach a more consistent and reliable conclusion.

Material-methods: The present meta-analysis was registered to PROSPERO (CRD42023467933). We utilized the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guideline to report the outcomes. Articles published before 1 October 2023 were included in the study. The search terms used were teratozoospermia, isolated teratozoospermia, varicocoelectomy for isolated teratozoospermia, and semen analysis after varicocoelectomy in isolated teratozoospermia.

Results: We identified 1,013 studies in full publications or abstracts using the methodology and the search terms. Five studies were included for systematic review, while four were included for meta-analysis. The five studies (10-14) included 348 patients aged 18-44 years. The pooled analysis revealed a significant improvement in sperm morphology in isolated teratozoospermia patients undergoing varicocoelectomy (Q = 199.42, p < 0.0001; I2 = 98.49%). The pooled analysis revealed no significant improvement in sperm concentration in isolated teratozoospermia patients undergoing varicocoelectomy (Q = 5.69, p = 0.058; I2 = 64.85%). Three of the examined studies provided information regarding pregnancy rate and it was high in all studies. According to the Newcastle-Ottowa scale (NOS) assessment, the total quality score of all studies was 7. The funnel plot test demonstrated a visible asymmetry, and Begg and Mazumdar's rank correlation test confirmed the publication bias (p = 0.04).

Discussion: Varicocoelectomy can be an effective and reliable treatment option in patients with isolated morphology abnormalities and clinically palpable varicocoele.

Conclusion: This meta-analysis reported that varicocoelectomy may increase pregnancy rates by improving semen parameters in infertile men with isolated teratozoospermia, although this conclusion requires further evidence.

Keywords: male infertility; teratozoospermia; varicocoele; variococelectomy.

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References

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