Lipidomic analysis of seminal plasma in work-up of varicocele-associated male infertility

Background . Approximately 50 % of cases of infertility in couples are attributable to male factor. One of the most common causes of male infertility is varicose dilation of pampiniform plexus veins in spermatic cord, or varicocele. However, the fact that only in 10-45 % of cases microsurgical subinguinal varicocelectomy leads to a spontaneous pregnancy in a couple urges further search for a diagnostic marker which would be able to predict the success of surgical treatment of varicocele preoperatively. Aim . To study the features of lipid profile of seminal plasma in patients with varicocele and to evaluate the possibility of using lipidomic analysis of seminal plasma for patient selection prior to surgical treatment for varicocele. Materials and methods . Fifty three patients from infertile couples with varicocele and altered seminal parameters aged 18 to 44 years underwent microsurgical varicocelectomy as described by Marmar. All patients were treated in one department. The control group included 24 healthy normozoospermic men without varicocele who had proven fertility. The material for the study was the seminal plasma of men, lipid composition of which was determined by mass spectrometry. Results . No significant differences were found in lipid profiles of seminal plasma from men in control group and varicocele group, as well as in lipid profiles of seminal plasma obtained before and after surgery in same patients. Comparison of lipid profiles of seminal plasma provided by patients before microsurgical varicocelectomy, who had clinical effect ( n = 15) and who did not have clinical effect ( n = 16), revealed differences in level of HexCer-NDS d20:0/18:0 in the positive ion test and in levels of 8 other lipids in the negative ion test. These lipids are related to the oxidation of phospholipids, cardiolipins and phosphatidylethanolamines. Conclusion . The lipid profile of seminal plasma of patients who had clinical response to varicocele surgery is significantly different from the lipid profile of seminal plasma of non-responder patients.