SPERM DNA DAMAGE RATE AMONG INFERTILE PATIENTS WITH VARICOCELE

Abstract

Background: Varicocele has a common association with male hypofertility. The prevalence of clinical varicocele is about 15% among adults and adolescents. varicocele patients are at risk of infertility. Sperm deoxyribonucleic acid (DNA) fragmentation rate (SDFR) is considered a major factor in decreased fertilization ability in males with varicocele. Varicocele increases SDFR through heat stress, increased reactive oxygen species, and reduction in the level of total antioxidants. Objectives: To study the rate of sperm DNA fragmentation in patients with different grades of varicocele. Patients and methods: A prospective, case-control study was conducted at Azadi Teaching hospital in Duhok city / Iraq from March 2020 to December 2021. The study included 34 infertile patients with varicocele of different grades and 30 infertile patients without varicocele. Seminal fluid analysis was performed followed by sperm DNA analysis by Alkaline Comet Assay. The obtained data were analyzed using a Prism-GraphPad to compare the mean of parameters in patients and control subjects. Results: Sixty-four infertile patients were included. The mean of sperm immobility and abnormal morphology rates were statistically higher in infertile patients with varicocele compared with those without varicocele (39.56±12.63 Vs 28.07±4.541) and (51.59±23.00 Vs 34.79±15.72) respectively, (P<0.0001).The fluorescence microscopic images of sperm DNA of infertile patients with varicocele showed a clear migration to DNA tail (DNA damage) compared with sperm DNA of those without varicocele (8.195 ± 0.3799 Vs. 4.794 ± 0.2186) respectively (P<0.0001).The degree of sperm DNA damage was directly related to the degree of varicocele and was significant (P<0.0001). Conclusion: Sperm DNA damage rate was higher in infertile male patients with varicocele in comparison to those without varicocele and directly related to the grade of varicocele.