Impact of Varicocele Embolization on DNA Fragmentation Index (DFI) in Male Infertility

Abstract

The DNA fragmentation index (DFI) is a newer and potentially more reliable marker for male factor infertility, with higher values indicating poorer sperm genetic quality. This study assessed the effect of varicocele embolization on DFI in men with infertility. Conducted at a single center from January 2016 to September 2021, this retrospective study involved 22 patients with a mean age of 35.2 years (SD ± 4.1). After embolization, DFI decreased from 32.3% (SD ± 9.8) to 24.7% (SD ± 12.9; P = .010), representing a 7.6% reduction. DFI analysis was performed 3 months after the procedure. The embolization procedure had a 100% technical success rate with no moderate or severe adverse events. Pregnancy was achieved in 55% (12/22) of patients, whereas 14% (3/22) were lost to follow-up. There was an overall trend toward improvement in semen parameters, with sperm concentration significantly increasing (P = .023). In conclusion, varicocele embolization significantly reduced DFI values, which is linked to improved fertility rates.