Varicocelectomy May Improve Results for Sperm Retrieval and Pregnancy Rate in Non-Obstructive Azoospermic Men

Objective Improvement in sperm density and motility after varicocelectomy have been widely reported for men with oligoasthenoteratospermia (OAT),However the value of varicocelectomy in azoospermic men remain controversial.In this study we have evaluated the outcome of microsurgical varicocelectomy in nonobstructive azoospermic (NOA) men with clinical varicocele in five years in royan institute. MaterialsAndMethods A retrospective review of patients treated for NOA and varicocele from march 2011 to march 2016 was performed.Also we have compared MDTESE results of our 57 patients with NOA and clinical varicocele with 537 NOA patients without varicocele in royan institute. Results Of 57 patients who underwent varicocelectomy,eight patients (14%)had sperm on sperm analysis postoperatively.One of the patients was single,and one of them had spontaneous pregnancy(1/7)14%,and one had child with microinjection(1/7)14%.Of these 8 patients,6 had hypospermatogenesis pathology.Of 38 patients who underwent MDTESE ,14 patients (36%)had sperm on testis tissue that one of them had no egg fertilization and so the fertilization rate was (92%).Of these 13 patients,3 had live child birth (3/13)23%. Sperm retrieval rate (SRR) in NOA men without clinical varicocele was lower from those who had varicocele and NOA (22% vs 36%).Also live birth rate in NOA men with varicocelectomy was higher than NOA men without varicocele(23% vs 11%). Conclusion Microsurgical varicocelectomy in NOA men may positive effect on postoperative sperm in ejaculate and spontaneous or assisted pregnancy,but it seems that this effect is more significant on MDTESE results and following successful microinjection.Meanwhile SRR and live birth rate was higher in our patients compare to NOA men without clinical varicocele.