Varicocele is associated with abnormal retention of cytoplasmic droplets by human spermatozoa

Objective: To determine whether varicocele is associated with retention of sperm cytoplasmic droplets in infertile men. Design: Retrospective study. Setting: University infertility clinic. Patient(s): Nonazoospermic men with idiopathic (n = 69) and varicocele-asso ciated infertility (n = 73), and 20 fertile controls presenting for vasecto my. Intervention(s): None. Main Outcome Measures(s): Standard semen parameters and percentage of sperm atozoa with cytoplasmic droplets on Papanicolaou smears. Result(s): No statistically significant differences were found between the fertile and infertile groups with respect to semen volume. Fertile controls had significantly greater mean percent sperm motility and normal morpholog y than infertile men. The mean percentage of sperm with residual cytoplasm was statistically significantly different in all three groups. Infertile me n with varicocele had the highest percentage of sperm with cytoplasmic drop lets, the next highest level being in men with idiopathic infertility and t he lowest level in fertile controls (11.7 +/- 1.0, 8.1 +/- 0.9 and 3.2 +/- 0.4%, respectively, P<.0001). Conclusion(s): Our data show that idiopathic and even moreso, varicocele-re lated male infertility are conditions associated with impaired disposal of residual sperm cytoplasm by the testis and/or epididymis. These data provid e a possible mechanism for the observed semen abnormalities and reduced fer tility potential associated with varicocele and idiopathic male infertility . (Fertil Steril(R) 2000,74:461-4. (C) 2000 by American Society for Reprodu ctive Medicine.).