Adequacy of Sperm Count and Motility following Varicocelectomy in Clinical Varicocele Patients in a Tertiary Health Institution, Nigeria.

Abstract

Background: Varicocele is the commonest cause of male infertility, and varicocelectomy is the commonest surgery performed for such men. Although many studies have reported improvements in semen parameters following varicocelectomy, their adequacy in relation to WHO standards has received less attention. There are patients who, after undergoing varicocelectomy, still do not naturally cause pregnancy, sometimes due to inadequate improvements in these parameters. This oftentimes influences their acceptance of the procedure. This is a prospective interventional study aimed at determining the adequacy of improvements in semen parameters following varicocelectomy at UCTH in one year.

Methodology: Clinical varicoceles patients with subnormal seminograms, who met certain inclusion criteria and consented, were recruited. Participants underwent varicocelectomy, and their pre- and post-surgical seminograms were compared with the current WHO standards. A proforma was designed to record patients' data. Data were analyzed using SPSS version 25. Frequencies, percentages, means, and standard deviations were used to summarize data. Relevant tests of significance (Fisher's exact, Chi-square (X2), t-tests) were conducted at a confidence interval of 95 percent and p-value <0.05. Data were presented in charts and tables.

Results: Sixty-six percent were aged 31-40 years (mean of 35.14±8.76). The study revealed that there was improvement in mean sperm count from 15.2±1.6x10⁶ to 38.2±3.3x10⁶/ejaculate (p<0.001) and percentage motility from 23.4±1.7 to 37.9±1.8 (p<0.001) 3-6 months following varicocelectomy. There was also a significant decrease in the mean percentage of non-motile sperms from 56.4±2.1 to 42.1±1.7 (p<0.001). Although there were corresponding improvements in the mean morphology and sluggishly motile sperm, these changes were not statistically significant.

Conclusion: The study demonstrated that varicocelectomy improves seminogram adequately (in clinical varicocele patients) as recommended by the WHO.