A Novel Immunonutritional Index for Male Infertility: The Predictive Value of the HALP Score on Varicocelectomy Outcomes

IF 1.3 4区医学 Q3 ANDROLOGY

Andrologia Pub Date : 2026-03-26 DOI:10.1155/and/4494203

Yasin Aktaş, Mehmet Gökaslan, Ali Nihat Gökcan, Adem Tunçekin, Hakan Türk

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引用次数: 0

Abstract

Objective

Predicting the outcome of varicocele repair remains a challenge in cases of male infertility. The haemoglobin, albumin, lymphocyte and platelet (HALP) score is a novel index that reflects both systemic inflammation and immunonutritional status. This study aimed to investigate the predictive value of the preoperative HALP score on semen parameter improvement after microsurgical varicocelectomy.

Materials and methods

We retrospectively analysed 134 patients undergoing microsurgical subinguinal varicocelectomy. Surgical success at 6 months was defined as a >50% increase in total motile sperm count (TMSC), or a >100% increase for baseline TMSC of less than 5 million. We compared the preoperative HALP score, neutrophil-to-lymphocyte ratio (NLR) and systemic immune-inflammation index (SII) between the improvement and non-improvement groups. Multivariate logistic regression and receiver operating characteristic (ROC) curve analyses were performed to identify independent predictors of success.

Results

Significant improvement was achieved in 74 patients (55.2%). The median preoperative HALP score was significantly higher in the Improvement Group than in the Non-improvement Group (79 vs. 70, p = 0.048). While NLR and SII were significant in the univariate analysis, they lost statistical significance in the multivariate model. Even after adjusting for baseline parameters, the HALP score (≥75) remained a significant predictor of semen recovery (OR: 2.63, 95% CI: 1.01–6.87; p = 0.048), alongside preoperative TMSC. ROC curve analysis revealed that the HALP score had modestly statistically significant discriminative ability, with an area under the curve (AUC) of 0.600.

Conclusion

The preoperative HALP score is a novel, cost-effective and promising adjunctive biomarker for predicting improvement in semen parameters after varicocelectomy. A high HALP score indicates favourable immunonutritional reserves. Identifying patients with low HALP scores could allow for preoperative optimisation to improve surgical outcomes.

Abstract Image

查看原文本刊更多论文

一种新的男性不育症免疫营养指标：HALP评分对精索静脉曲张切除术结果的预测价值

目的预测男性不育症精索静脉曲张修复的预后仍然是一个挑战。血红蛋白、白蛋白、淋巴细胞和血小板（HALP）评分是一种反映全身炎症和免疫营养状况的新指标。本研究旨在探讨术前HALP评分对显微精索静脉曲张切除术后精液参数改善的预测价值。材料与方法我们回顾性分析了134例腹股沟下精索静脉曲张显微手术患者。6个月手术成功的定义为总活动精子数（TMSC）增加50%，或基线TMSC少于500万时增加100%。我们比较了改善组和非改善组术前HALP评分、中性粒细胞与淋巴细胞比值（NLR）和全身免疫炎症指数（SII）。采用多变量logistic回归和受试者工作特征（ROC）曲线分析来确定成功的独立预测因素。结果74例患者（55.2%）获得显著改善。改善组术前HALP评分中位数明显高于非改善组（79比70，p = 0.048）。NLR和SII在单因素分析中具有显著性，但在多因素模型中失去统计学意义。即使在调整基线参数后，与术前TMSC相比，HALP评分（≥75）仍然是精液恢复的重要预测因子（OR: 2.63, 95% CI: 1.01-6.87; p = 0.048）。ROC曲线分析显示，HALP评分具有适度统计学显著的判别能力，曲线下面积（AUC）为0.600。结论术前HALP评分是预测精索静脉曲张切除术后精液参数改善的一种新颖、经济、有前景的辅助生物标志物。高的HALP分数表明良好的免疫营养储备。识别低HALP评分的患者可以允许术前优化以改善手术结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Andrologia 医学-男科学

CiteScore

5.60

自引率

8.30%

发文量

292

审稿时长

6 months

期刊介绍： Andrologia provides an international forum for original papers on the current clinical, morphological, biochemical, and experimental status of organic male infertility and sexual disorders in men. The articles inform on the whole process of advances in andrology (including the aging male), from fundamental research to therapeutic developments worldwide. First published in 1969 and the first international journal of andrology, it is a well established journal in this expanding area of reproductive medicine.