Seminal plasma clusterin as a biomarker for spermatogenesis in patients with varicocele before and after varicocelectomy

Introduction: A varicoc ele is an abnormally dilated pampiniform plexus of veins. Hyperthermia, oxidative stress, and elevated apoptotic index have been described in men with varicocele and infertility. Clusterin (Clu) is a chaperone-like glycoprotein that is synthesized by Sertoli cells in high concentrations and is deposited onto the membranes of mature spermatozoa, giving rise to the possibility that it has a role in sperm development. Secreted form of Clu is a powerful anti-apoptotic agent.  Aim: To explore Clu level in seminal plasma of infertile men with varicocele in comparison with normal healthy fertile patients and to compare the seminal plasma Clu level before and after varicocelectomy.Patients and methods: The study included 25 patients having varicocele with infertility (whether primary or secondary) for 12 months and 10 healthy volunteers of matched age and sex as control. For all the patients, sub-inguinal varicocelectomy was done. Semen analysis and seminal plasma Clu assay were carried out before and 3 months after varicocelectomy.Results: There was a statistically significant difference between patients and controls regarding sperm count, progressive motility, and seminal plasma Clu (P<0.01). Three months after varicocelectomy, the sperm count had a highly significant improvement in the patient’s group (mean ± SD=17.90 ± 8.86) compared with a preoperative count (mean ± SD=11.43 ± 7.56). There was a highly significant improvement in postoperative progressive motility in the patient’s group (mean ± SD=34.5 ± 20.2) compared with preoperative progressive motility (mean ± SD=22.05 ± 15.5).Clu showed a highly significant elevation in the patient group postoperatively (mean ± SD=10.73 ± 4.5) compared with preoperatively (mean ± SD=6.68 ± 3.8).  Conclusion: Based on our study, we could suggest another way of contribution of varicocele to male infertility by affecting seminal plasma Clu level.