Correlation between seminal α-glycerylphosphorylcholine and semen parameters in infertile patients pre- and post-sub-inguinal micro-varicocelectomy: a prospective study.

Abstract

Background: Varicocele (Vx) which is the most treatable cause of male infertility, is also associated with low sperm count, decreased sperm motility and increased sperm abnormal morphology. We aimed in the current study to evaluate the correlation between seminal α-Glycerylphosphorylcholine (αGPC) and semen parameters in infertile patients pre- and post- sub-inguinal micro-varicocelectomy.

Methods: The current comparative prospective study was carried out on 20 male patients who presented to Kasr Al-Ainy Hospitals from March 2022 to March 2023 as well as 20 healthy controls. The participants were divided into groups as follows: group (1) included fertile normozoospermic men (n = 20) who served as controls. Group (2) included infertile oligoasthenoteratozoospermia (OAT) men with varicocele (n = 20). Patients in group (2) were followed up to 3 months after microsurgical sub-inguinal Varicocelectomy. The examination included an assessment of Vx with scrotal Duplex. Semen analysis was done according to the 5th Edition of WHO manual for semen analysis.

Results: The study demonstrates that αGPC level was significantly higher among fertile normozoospermic control group and infertile OAT men post varicocelectomy when compared to infertile OAT men preoperative (p<0.001). Moreover, it demonstrates that on follow up of infertile OAT group 3 months after sub-inguinal micro-varicocelectomy, all semen parameters showed significant improvement compared to the corresponding semen parameters pre-operatively among Vxs grade II and grade III (p<0.001, p<0.001, respectively). A significant positive correlation was found between αGPC level and semen parameters including sperm normal forms, sperm count and sperm motility. Using ROC curve, αGPC protein showed a sensitivity of (100%) and a specificity of (100%) at cut off value (≤ 1.975 pg/ml) in differentiation between infertile OAT patients with Vx and control fertile normozoospermic men (p<0.001).

Conclusions: αGPC may play an important role in infertility in men with Vx and correction of Vx improves the seminal αGPC level.