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Varicocele and semen quality: a retrospective case–control study of 4230 patients from a single centre

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Abstract

Purpose

The aim of the present study is to assess impairment of spermatogenesis induced by varicocele in, to our knowledge, the largest single-centre caseload available to date.

Materials and methods

We conducted a retrospective study on 4230 consecutive patients attending our Department for andrological outpatient assessment and preconception check-ups between 2011 and 2014. A total of 2113 patients had varicocele (Group V), while the remaining 2117 were selected as the control group (Group C). All patients were divided into age classes (<17, 18–28, 29–39 and ≥40 years), and Group V patients were classified as “low” (I–II) or “high” (III–IV) grade.

Results

Varicocele patients had a higher mean height than controls, as well as lower BMI. There was also a statistically significant reduction in the concentration/mL and the total sperm number in Group V against Group C. When stratified by age, values for all semen parameters were significantly worse in the older than in the younger age classes in both Group V and Group C, except for concentration/mL and total sperm number in the 29–39 and ≥40 age classes in both groups. A multivariable logistic regression analysis showed that factors independently predicting the presence of varicocele were older age, higher BMI and smoking for more than 10 years.

Conclusions

Varicocele patients show worse semen parameters compared to controls, although their values were still within WHO reference limits. Semen quality is further worsened by increased age, grade and chronic smoking.

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Acknowledgements

This work is dedicated to the memory of Prof. Loredana Gandini, who carried out the semen analyses in this study. The authors wish to thank Marie-Hélène Hayles for her assistance in the English translation of the manuscript.

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Authors and Affiliations

  1. Laboratory of Seminology-Sperm Bank “Loredana Gandini”, Department of Experimental Medicine, “Sapienza” University of Rome, Viale del Policlinico 155, 00161, Rome, Italy

    F. Pallotti, D. Paoli, T. Carlini, A. Lenzi & F. Lombardo

  2. Department of Public Health and Infectious Diseases, “Sapienza” University of Rome, Rome, Italy

    A. R. Vestri

  3. Department of Surgical Sciences “R. Paolucci”, “Sapienza” University of Rome, Rome, Italy

    G. Martino

Authors
  1. F. Pallotti
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  2. D. Paoli
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  3. T. Carlini
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  4. A. R. Vestri
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  5. G. Martino
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  6. A. Lenzi
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  7. F. Lombardo
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Corresponding author

Correspondence to F. Lombardo.

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Conflict of interest

The authors have no conflicts of interest.

Financial support

This work was supported by a grant from the Italian Ministry of Education and Research (MIUR-PRIN) and “Sapienza” University of Rome, Faculty of Medicine.

Ethical approval

This retrospective research was approved by our University Hospital’s institutional review board (Protocol 419/16).

Informed consent

Informed consent was obtained from all individual partecipants included in the study.

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Pallotti, F., Paoli, D., Carlini, T. et al. Varicocele and semen quality: a retrospective case–control study of 4230 patients from a single centre. J Endocrinol Invest 41, 185–192 (2018). https://doi.org/10.1007/s40618-017-0713-z

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  • DOI: https://doi.org/10.1007/s40618-017-0713-z

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