THE OUTCOME OF VARICOCELECTOMY IN SUBFERTILE MEN WITH AN ABSENT OR ATROPHIC RIGHT TESTIS

Objectives To determine the effects of varicocelectomy on semen qualit y, testicular volumes and serum hormone levels in subfertile men with an absent or atrophic right testis. Patients and methods Seventeen pat ients whose wives were gynaecologically normal were evaluated with at least two semen analyses and measurements of serum hormone levels and antisperm antibodies. Scrotal ultrasonography was used to determine te sticular volumes and spermatic vein diameters. Varicocelectomy was per formed by high ligation via an inguinal approach. All patients were se en at a follow-up 3 months later, and after 6, 9 and 12 months the scr otal ultrasonography, hormone assessment and semen analyses were repea ted, Any pregnancies in their wines were recorded over a median follow -up of 19 months. Results After surgery, all patients had significant improvements in sperm motility, morphology and concentration (P<0.01) but the differences in pre- and post-operative testicular volumes and plasma hormone levels were not statistically significant: (P > 0.01). No patients had immunological infertility, Eleven of the wives became pregnant during the follow-up. Conclusion Higher pregnancy rates can b e achieved by left varicocelectomy in subfertile men with an absent or atrophic right testis. Sperm concentration, motility and morphology a n significantly improved by varicocelectomy.