Mh. Vazquezlevin et al., RESPONSE OF ROUTINE SEMEN ANALYSIS AND CRITICAL-ASSESSMENT OF SPERM MORPHOLOGY BY KRUGER CLASSIFICATION TO THERAPEUTIC VARICOCELECTOMY, The Journal of urology, 158(5), 1997, pp. 1804-1807
Purpose: We studied tile effect of varicocelectomy on Kruger morpholog
y and semen parameters, Materials and Methods: A total of 33 subfertil
e men diagnosed with varicoceles was evaluated 3 months before, anti 3
to 4 and 6 to 8 months after varicocelectomy. Evaluation involved rou
tine semen analysis and sperm morphology using Kruger classification.
Results: Significant improvement in sperm concentration and count was
found after varicocelectomy (sperm count preoperatively 117.1 +/- 29,
3 to 4 months postoperatively 162.5 +/- 41 and 6 to 8 months postopera
tively 139.8 +/- 25 million sperm, p = 0.0095). Using Kruger classific
ation, evaluation of sperm morphology revealed overall significant inc
rease in percentage of normal A forms at 3 to 4 and 6 to 8 months afte
r surgery (from 9.8 +/- 5.8% A forms, 13.6 +/- 7.7% A forms, and 14.5
+/- 7.5% A forms, respectively, p = 0.0002, normal greater than 14%).
Twelve of the 26 patients (46%) with abnormal sperm morphology preoper
atively and greater than 4% A forms reached normal levels 3 months pos
toperatively. Six months after surgery only 6 patients maintained norm
al values and 3 of the initial 14 nonresponders became: normal (9 of 2
6, 36%). Three patients with severe teratozoospermia (less than 4% A f
orms) showed improvement in sperm morphology. Four patients with norma
l sperm morphology preoperatively were not affected by varicocelectomy
. Conclusions: Surgical correction of varicocele was associated with s
ignificant; improvement in sperm morphology evaluated using Kruger cla
ssification. Concentration and count improved after varicocelectomy. C
hanges were observed as early as 3 months after surgery.