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The Effect of Varicocelectomy on Semen Analysis and Serum Levels of InhibinB

Mohammadreza Mohammadi Fallah, Ali Tayyebi Azar




Background: Varicocele means dilation and torsion of spermatic veins. About 15%-40% of infertile men suffer from Varicocele. It seems that 70% of secondary infertility in men occurs due to Varicocele. Varicocele is the most common surgical cause for male infertility. Varicocelectomy is considered as the best treatment method for patients with Varicocele that increases 30%-50% of the postoperative fertility rate. The purpose of this study was to investigate the effect of Varicocelectomy on inhibin B and use this marker to predict infertility in men.

Methods: In this study, all infertile patients in any age that were candidate for Varicocelectomy and hospitalized in Imam Hospital in Urmia were included. Exclusion criteria were defined as orchitis, trauma, diabetes, radiotherapy, chemotherapy and coitus complications. Sperm analysis (SA) was conducted three times for patients and then serum levels of FSH, LH, T, inhibin B, SA were measured before surgery and also six months after surgery. Furthermore, during the hospitalization and infertility period, testes were examined before surgery in terms of consistency and size.

Results: The mean ± SEM (standard error median) age of 40 patients was 28.4±5.14 (range: 18-40) years old. Mean size of the testes and mean sperm density and serum levels of LH.FSH remained the same. However, mean sperm motility, serum levels of T and inhibin B were statistically significant after the Varicocelectomy (p-value=0.005). A significant relationship was found between serum levels of inhibin B and infertility; however, there was no significant relationship between sperm count and serum levels of LH, FSH and T. Varicocelectomy can improve sperm motility and increase Inhibin B in patients and so improves spermatogenesis parameters and it may be one of the causes of fertility in patients.

Conclusion: The results of this study indicate that sperm motility and increase in inhibin B after Varicocelectomy can improve spermatogenesis parameters. Serum levels of FSH, T, LH and sperm morphology and also grade of Varicocele, patient age, and testis size have no effect on spermatogenesis and fertility after Varicocelectomy.



Lipshultz L, Thomas A, Khera M. Surgical management of male infertility. Campbell-Walsh Urology. 2007;1(9):654-717.

Romeo C, Arrigo T, Impellizzeri P, Manganaro A, Antonuccio P, Di Pasquale G, et al. Altered serum inhibin b levels in adolescents with varicocele. Journal of pediatric surgery. 2007;42(2):390-4.

Dohle G, Jungwirth A, Colpi G, Giwercman A, Diemer T, Hargreave T. Guidelines on. Update. 2007.

Di Bisceglie C, Bertagna A, Baldi M, Lanfranco F, Tagliabue M, Gazzera C, et al. Varicocele sclerotherapy improves serum inhibin B levels and seminal parameters. International journal of andrology. 2007;30(6):531-6.

Zhang J, Jin P, Gong M, Guo J, Fang K, Yi Q, et al. Roles of Fas/FasL‐mediated apoptosis and inhibin B in the testicular dysfunction of rats with left‐side varicocele. Andrologia. 2018;50(2):e12850.

Fujisawa M, Dobashi M, Yamasaki T, Kanzaki M, Okada H, Arakawa S, et al. Significance of serum inhibin B concentration for evaluating improvement in spermatogenesis after varicocelectomy. Human Reproduction. 2001;16(9):1945-9.

Molinaro F, Cerchia E, Garzi A, Severi FM, Angotti R, Petraglia F, et al. Serum levels of Inhibin B in adolescents after varicocelelectomy: A long term follow up. Open Medicine. 2016;11(1):204-6.

Pierik FH, Abdesselam SA, Vreeburg J, Dohle G, De Jong FH, Weber RF. Increased serum inhibin B levels after varicocele treatment. Clinical endocrinology. 2001;54(6):775-80.

Dadfar M, Ahangarpour A, Habiby A, Khazaely D. Pre-operative serum level of inhibin B as a predictor of spermatogenesis improvement after varicocelectomy. Urology journal. 2010;7(2):110.

Ozden C, Ozdal OL, Bulut S, Guzel O, Koyuncu HH, Memis A. Effect of varicocelectomy on serum inhibin B levels in infertile patients with varicocele. Scandinavian journal of urology and nephrology. 2008;42(5):441-3.

Türkyılmaz Z, Karabulut R, Sönmez K, Demiroğulları B, Özen O, Moralıoğlu S, et al. Inhibin B levels in peripheral vein do not correlate with inhibin B levels in the spermatic vein in adolescents with varicocele. Archives of andrology. 2006;52(4):325-8.

Basar MM, Kisa U, Tuglu D, Kacmaz M, Basar H. The effect of varicocele on seminal plasma and serum inhibin-B levels in adolescent and adult men. International urology and nephrology. 2010;42(1):47-51.

Nowroozi M-R, Radkhah K, Ayati M, Jamshidian H, Ranjbaran A, Jabalameli P. Serum inhibin B concentration as a prognostic factor for prediction of sperm retrieval in testis biopsy of patients with azoospermia. Arch Iran Med. 2008;11(1):54-6.

Vernaeve V, Tournaye H, Schiettecatte J, Verheyen G, Steirteghem AV, Devroey P. Serum inhibin B cannot predict testicular sperm retrieval in patients with non-obstructive azoospermia. Human Reproduction. 2002;17(4):971-6.

Ballescá JL, Balasch J, Calafell JM, Alvarez R, Fábregues F, de Osaba MJM, et al. Serum inhibin B determination is predictive of successful testicular sperm extraction in men with non-obstructive azoospermia. Human Reproduction. 2000;15(8):1734-8.

Niu X, Tang J, Wang H, Yan L, Zhang C, Wang G, et al. Inhibin B level helps evaluate the testicular function of prepubertal patients with varicocele. Zhonghua nan ke xue= National journal of andrology. 2018;24(7):618-21.


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