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Varicocelectomy

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A Clinician's Guide to Sperm DNA and Chromatin Damage

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Abstract

Varicocele is defined as a dilatation of the pampiniform plexus veins. It is a common condition affecting both men with normal spermatogenesis and men with abnormal semen parameters. Recent pathophysiology studies have indicated that varicocele exacerbates the generation of reactive oxygen species (ROS). Excessive ROS results in oxidative stress (OS) that may affect the sperm chromatin integrity and consequently fertility. Damage to the sperm chromatin may result in sperm DNA fragmentation (SDF), a condition that has been associated with varicocele-related infertility. Although sperm with fragmented DNA are able to fertilize an oocyte with apparently similar efficiency as sperm without DNA fragmentation, DNA-damaged sperm may negatively impact the embryo development. In fact, SDF has been associated not only with infertility but also with poor outcomes in assisted reproduction treatments, including miscarriage. On the contrary, varicocele repair may alleviate OS and reduce SDF, thus leading to improved fertility both natural and assisted.

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Authors and Affiliations

  1. ORIGEN - Center for Reproductive Medicine, Rio de Janeiro, Brazil

    Matheus Roque

  2. Andrology and Human Reproduction Clinic, ANDROFERT, Campinas, Brazil

    Sandro C. Esteves

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Editors and Affiliations

  1. Department of Surgery, Division of Urology, McGill University, Montreal, Québec, Canada

    Armand Zini

  2. American Center for Reproductive Medicine, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, Ohio, USA

    Ashok Agarwal

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Roque, M., Esteves, S.C. (2018). Varicocelectomy. In: Zini, A., Agarwal, A. (eds) A Clinician's Guide to Sperm DNA and Chromatin Damage. Springer, Cham. https://doi.org/10.1007/978-3-319-71815-6_26

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