Sperm ultramorphology as a pathophysiological indicator of spermatogenesisin males suffering from varicocele

Varicocele of spermatic veins is considered to be one of the major causes o f male infertility associated with reduction of sperm quality. The pathophy siology of this condition is not yet completely understood. The aim of this study was to shed light on the pathophysiology of varicocele by identifyin g semen parameters, especially sperm ultramorphology, which improve followi ng high ligation of the spermatic vein. Seventy-five males with diagnosed v aricocele were included in this study. Semen parameters were assessed prosp ectively using light microscopy, semen biochemistry and sperm quantitative ultramorphological analysis, before high ligation and 3-9 months after high ligation. The control group consisted of twenty-five untreated varicocele patients who underwent two semen examinations within 3-9 months. No statist ical difference in any of the examined variables was found between the two examinations in the control group. The treated patients exhibited a signifi cant improvement in sperm density, progressive motility, percentage of norm ally formed spermatozoa, agenesis of sperm acrosome, chromatin condensation and incidence of amorphous heads compared with the pretreatment condition (P less than or equal to 0.01). In contradiction, no significant improvemen t was observed following treatment in any of the sperm tail subcellular org anelles. It is concluded that varicocele may cause deleterious alterations in early spermatid head differentiation during spermiogenesis and that vari cocele patients with a high incidence of sperm acrosome and nucleus malform ations are appropriate candidates for varicocele correction.