Predictive indicators of successful varicocele repair in men with infertility

Objective-We sought predictive indicators of functionally successful repair in 168 infertile Japanese males who underwent high ligation of a varicocel e via a retroperitoneal approach. Methods-Possible indicators evaluated inc luded age at marriage, duration of infertility, testicular volume, varicoce le grade, seminal analysis findings, and serum concentrations of follicle-s timulating hormone (FSH), luteinizing hormone (LH), prolactin (PRL), and te stosterone. All patients had palpable or visible unilateral left varicocele s. Success in conception was evaluated in all subjects 1 year after varicoc ele repair. Results-No associations were observed between outcome and mean age at marriage, infertility duration, varicocele grade, seminal volume, or serum PRL and testosterone concentrations, but testicular volume, sperm co unt, percentage of motile sperm, and serum FSH and LH concentrations were s ignificantly associated with outcome. Multiple regression analysis of depen dence of outcome revealed testicular volume and serum FSH concentrations to be independent predictors. Conclusions-Varicocele repair is likely to acco mplish fertility in patients with a combined testicular volume of at least 30 mL or serum FSH concentrations lower than 11.7 mIU/mL.