Impact of Varicocele Repair on Assisted Reproductive Technique Outcomes in Infertile Men: A Systematic Review and Meta-Analysis
Purpose: In this systematic review and meta-analysis, we investigated assisted reproductive technology (ART) success in infertile men with clinical varicocele and abnormal semen parameters who underwent varicocele repair (VR) before the ART procedure as compared to those who did not. Materials an...
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| Main Authors: | , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Korean Society for Sexual Medicine and Andrology
2025-04-01
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| Series: | The World Journal of Men's Health |
| Subjects: | |
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| Summary: | Purpose: In this systematic review and meta-analysis, we investigated assisted reproductive technology (ART) success in infertile
men with clinical varicocele and abnormal semen parameters who underwent varicocele repair (VR) before the ART
procedure as compared to those who did not.
Materials and Methods: A comprehensive search of the Scopus, PubMed, Embase, and Cochrane Library databases was conducted
using a specific query string to identify studies examining the impact of VR on ART outcomes, including fertilization
rate, clinical pregnancy, pregnancy loss, and live-birth rate, until October 2023. Outcomes were analyzed based on the type
of ART. Studies on VR in infertile men with non-obstructive azoospermia and those who underwent ART only due to female
factor infertility were excluded from the study.
Results: Out of 1,554 articles reviewed, only 9 met the inclusion criteria for the study. All the included articles were observational
studies. The variability in study quality in the included literature resulted in a moderate overall risk of bias. Data
analysis showed that for intrauterine insemination, there was no difference in the clinical pregnancy rate (odds ratio [OR]
1.01, 95% confidence interval [CI]: 0.42, 2.45; p=0.97). However, for intracytoplasmic sperm injection (ICSI), men with VR
showed a significant improvement in fertilization rate (mean difference 10.9, 95% CI: 5.94, 15.89; p<0.01), clinical pregnancy
rate (OR 1.38, 95% CI: 1.07, 1.78; p=0.01) and live-birth rate (OR 2.07, 95% CI: 1.45, 2.97; p<0.01), compared to men
who did not undergo VR. Conclusions: The findings of this systematic review and meta-analysis suggest that VR has a positive impact on pregnancy
and live birth rates after ICSI. However, biases like small sample sizes and heterogeneous populations highlight the need for
larger, well-designed prospective studies to validate these findings. |
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| ISSN: | 2287-4208 2287-4690 |