The aim of the present study is to evaluate the possible effects of varicocele
and varicocelectomy on serum levels of some sex hormones and on seminal plasma
transferrin as a marker of Sertoli cell function. This study included 20 healthy
normozoospermic fertile male volunteers as a normozoospermic group and 40
infertile male patients with grade II bilateral varicocele, classified into two groups;
oligospermic group included 30 patients and azoospermic group included 10 patients.
Serum testosterone, follicle stimulating hormone (FSH), estradiol (E2), prolactin
(PRL) and seminal plasma transferrin levels were estimated in all cases before and 3
months after varicocelectomy in both patient groups. Pre-varicocelectomy, there was
a significant decrease (P<0.05) in serum testosterone and significant increases
(P<0.05) in serum FSH and E2 in both oligospermic and azoospermic groups as
compared to the normozoospermic group. Post-varicocelectomy, serum testosterone
was still significantly lower and serum FSH and E2 were still significantly higher
(P<0.05) in azoospermic group only as compared to normal group. Postvaricocelectomy,
testosterone levels were significantly increased (P<0.05) and FSH
levels were significantly decreased (P<0.05) in both patient groups when compared
with theft pre-varicocelectomy levels, while post-varicocelectomy E2 mean level was
significantly decreased (P<0.05) in oligospermic group as compared to prevaricocelectomy
level. Seminal plasma transferrin pre-varicocelectomy, was
significantly decreased (P<0.001) in both oligospermic and azoospermic groups when
compared with normozoospermic group. Post-varicocelectomy seminal plasma
transferrin was higher, but the elevation was insignificant, in both patient groups
when compared with pre-operative transferrin level. There was a positive significant
correlation (r=0.69; P<0.001) between seminal plasma transferrin and sperm count in
oligospermic group, but there were non-significant correlations between seminal
plasma transferrin and other seminal parameters. It could be concluded that, men
suffering from varicocele have lower mean sperm count and worse seminal
parameters than those without varicocele. Varicocelectomy might promote the Sertoli
and Leydig cell functions. The significant increase in serum testosterone levels
resulted in significant improvement of sperm concentration, and motility. This work
suggested that in men with azoospermia and oligosperrnia, who had palpable
varicocele and increased pre-operative serum FSH levels, varicocelectomy may not be
contraindicated and that still there is a hope of improving their fertility. Also, the
findings of improvements in seminal parameters after varicocelectomy but non significant changes in seminal transferrin levels indicates that varicocelectomy results
in a greater improvement in sperm quality than in Sertoli cell function. |
