Impact of Varicocele Repair on Assisted Reproductive Technique Outcomes in Infertile Men: A Systematic Review and Meta-Analysis
In this systematic review and meta-analysis, we investigated assisted reproductive technology (ART) success in infertile men with clinical varicocele and abnormal semen parameters who underwent varicocele repair (VR) before the ART procedure as compared to those who did not. A comprehensive search o...
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| Veröffentlicht in: | The world journal of men's health 2024-09, Vol.42 |
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| creator | Palani, Ayad Cannarella, Rossella Saleh, Ramadan Salvio, Gianmaria Harraz, Ahmed M Crafa, Andrea Bahar, Fahmi Bocu, Kadir Kumar, Naveen Kothari, Priyank Pinggera, Germar-Michael Cayan, Selahittin Colpi, Giovanni M Atmoko, Widi Shah, Rupin Agarwal, Ashok |
| description | In this systematic review and meta-analysis, we investigated assisted reproductive technology (ART) success in infertile men with clinical varicocele and abnormal semen parameters who underwent varicocele repair (VR) before the ART procedure as compared to those who did not.
A comprehensive search of the Scopus, PubMed, Embase, and Cochrane Library databases was conducted using a specific query string to identify studies examining the impact of VR on ART outcomes, including fertilization rate, clinical pregnancy, pregnancy loss, and live-birth rate, until October 2023. Outcomes were analyzed based on the type of ART. Studies on VR in infertile men with non-obstructive azoospermia and those who underwent ART only due to female factor infertility were excluded from the study.
Out of 1,554 articles reviewed, only 9 met the inclusion criteria for the study. All the included articles were observational studies. The variability in study quality in the included literature resulted in a moderate overall risk of bias. Data analysis showed that for intrauterine insemination, there was no difference in the clinical pregnancy rate (odds ratio [OR] 1.01, 95% confidence interval [CI]: 0.42, 2.45; p=0.97). However, for intracytoplasmic sperm injection (ICSI), men with VR showed a significant improvement in fertilization rate (mean difference 10.9, 95% CI: 5.94, 15.89; p |
| doi_str_mv | 10.5534/wjmh.240132 |
| format | Article |
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A comprehensive search of the Scopus, PubMed, Embase, and Cochrane Library databases was conducted using a specific query string to identify studies examining the impact of VR on ART outcomes, including fertilization rate, clinical pregnancy, pregnancy loss, and live-birth rate, until October 2023. Outcomes were analyzed based on the type of ART. Studies on VR in infertile men with non-obstructive azoospermia and those who underwent ART only due to female factor infertility were excluded from the study.
Out of 1,554 articles reviewed, only 9 met the inclusion criteria for the study. All the included articles were observational studies. The variability in study quality in the included literature resulted in a moderate overall risk of bias. Data analysis showed that for intrauterine insemination, there was no difference in the clinical pregnancy rate (odds ratio [OR] 1.01, 95% confidence interval [CI]: 0.42, 2.45; p=0.97). However, for intracytoplasmic sperm injection (ICSI), men with VR showed a significant improvement in fertilization rate (mean difference 10.9, 95% CI: 5.94, 15.89; p<0.01), clinical pregnancy rate (OR 1.38, 95% CI: 1.07, 1.78; p=0.01) and live-birth rate (OR 2.07, 95% CI: 1.45, 2.97; p<0.01), compared to men who did not undergo VR.
The findings of this systematic review and meta-analysis suggest that VR has a positive impact on pregnancy and live birth rates after ICSI. However, biases like small sample sizes and heterogeneous populations highlight the need for larger, well-designed prospective studies to validate these findings.</description><identifier>ISSN: 2287-4208</identifier><identifier>EISSN: 2287-4690</identifier><identifier>DOI: 10.5534/wjmh.240132</identifier><identifier>PMID: 39344117</identifier><language>eng</language><publisher>Korea (South)</publisher><ispartof>The world journal of men's health, 2024-09, Vol.42</ispartof><rights>Copyright © 2024 Korean Society for Sexual Medicine and Andrology.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c177t-69a32ee7f6d02400150f59f4f15ed25b54dedba383a617764250c505e88e8643</cites><orcidid>0000-0003-0503-3533 ; 0000-0001-6463-2494 ; 0000-0003-4784-2208 ; 0000-0003-0585-1026 ; 0000-0001-9290-5699 ; 0000-0002-7868-5949 ; 0000-0002-8311-9095 ; 0000-0003-4323-4037 ; 0000-0001-6176-6913 ; 0000-0002-7793-7083 ; 0000-0002-8902-517X ; 0000-0001-7806-9903 ; 0000-0003-1431-1777 ; 0000-0002-7027-9436 ; 0000-0002-3940-952X ; 0000-0003-4599-8487</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,860,27901,27902,33722</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39344117$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Palani, Ayad</creatorcontrib><creatorcontrib>Cannarella, Rossella</creatorcontrib><creatorcontrib>Saleh, Ramadan</creatorcontrib><creatorcontrib>Salvio, Gianmaria</creatorcontrib><creatorcontrib>Harraz, Ahmed M</creatorcontrib><creatorcontrib>Crafa, Andrea</creatorcontrib><creatorcontrib>Bahar, Fahmi</creatorcontrib><creatorcontrib>Bocu, Kadir</creatorcontrib><creatorcontrib>Kumar, Naveen</creatorcontrib><creatorcontrib>Kothari, Priyank</creatorcontrib><creatorcontrib>Pinggera, Germar-Michael</creatorcontrib><creatorcontrib>Cayan, Selahittin</creatorcontrib><creatorcontrib>Colpi, Giovanni M</creatorcontrib><creatorcontrib>Atmoko, Widi</creatorcontrib><creatorcontrib>Shah, Rupin</creatorcontrib><creatorcontrib>Agarwal, Ashok</creatorcontrib><title>Impact of Varicocele Repair on Assisted Reproductive Technique Outcomes in Infertile Men: A Systematic Review and Meta-Analysis</title><title>The world journal of men's health</title><addtitle>World J Mens Health</addtitle><description>In this systematic review and meta-analysis, we investigated assisted reproductive technology (ART) success in infertile men with clinical varicocele and abnormal semen parameters who underwent varicocele repair (VR) before the ART procedure as compared to those who did not.
A comprehensive search of the Scopus, PubMed, Embase, and Cochrane Library databases was conducted using a specific query string to identify studies examining the impact of VR on ART outcomes, including fertilization rate, clinical pregnancy, pregnancy loss, and live-birth rate, until October 2023. Outcomes were analyzed based on the type of ART. Studies on VR in infertile men with non-obstructive azoospermia and those who underwent ART only due to female factor infertility were excluded from the study.
Out of 1,554 articles reviewed, only 9 met the inclusion criteria for the study. All the included articles were observational studies. The variability in study quality in the included literature resulted in a moderate overall risk of bias. Data analysis showed that for intrauterine insemination, there was no difference in the clinical pregnancy rate (odds ratio [OR] 1.01, 95% confidence interval [CI]: 0.42, 2.45; p=0.97). However, for intracytoplasmic sperm injection (ICSI), men with VR showed a significant improvement in fertilization rate (mean difference 10.9, 95% CI: 5.94, 15.89; p<0.01), clinical pregnancy rate (OR 1.38, 95% CI: 1.07, 1.78; p=0.01) and live-birth rate (OR 2.07, 95% CI: 1.45, 2.97; p<0.01), compared to men who did not undergo VR.
The findings of this systematic review and meta-analysis suggest that VR has a positive impact on pregnancy and live birth rates after ICSI. 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A comprehensive search of the Scopus, PubMed, Embase, and Cochrane Library databases was conducted using a specific query string to identify studies examining the impact of VR on ART outcomes, including fertilization rate, clinical pregnancy, pregnancy loss, and live-birth rate, until October 2023. Outcomes were analyzed based on the type of ART. Studies on VR in infertile men with non-obstructive azoospermia and those who underwent ART only due to female factor infertility were excluded from the study.
Out of 1,554 articles reviewed, only 9 met the inclusion criteria for the study. All the included articles were observational studies. The variability in study quality in the included literature resulted in a moderate overall risk of bias. Data analysis showed that for intrauterine insemination, there was no difference in the clinical pregnancy rate (odds ratio [OR] 1.01, 95% confidence interval [CI]: 0.42, 2.45; p=0.97). However, for intracytoplasmic sperm injection (ICSI), men with VR showed a significant improvement in fertilization rate (mean difference 10.9, 95% CI: 5.94, 15.89; p<0.01), clinical pregnancy rate (OR 1.38, 95% CI: 1.07, 1.78; p=0.01) and live-birth rate (OR 2.07, 95% CI: 1.45, 2.97; p<0.01), compared to men who did not undergo VR.
The findings of this systematic review and meta-analysis suggest that VR has a positive impact on pregnancy and live birth rates after ICSI. However, biases like small sample sizes and heterogeneous populations highlight the need for larger, well-designed prospective studies to validate these findings.</abstract><cop>Korea (South)</cop><pmid>39344117</pmid><doi>10.5534/wjmh.240132</doi><orcidid>https://orcid.org/0000-0003-0503-3533</orcidid><orcidid>https://orcid.org/0000-0001-6463-2494</orcidid><orcidid>https://orcid.org/0000-0003-4784-2208</orcidid><orcidid>https://orcid.org/0000-0003-0585-1026</orcidid><orcidid>https://orcid.org/0000-0001-9290-5699</orcidid><orcidid>https://orcid.org/0000-0002-7868-5949</orcidid><orcidid>https://orcid.org/0000-0002-8311-9095</orcidid><orcidid>https://orcid.org/0000-0003-4323-4037</orcidid><orcidid>https://orcid.org/0000-0001-6176-6913</orcidid><orcidid>https://orcid.org/0000-0002-7793-7083</orcidid><orcidid>https://orcid.org/0000-0002-8902-517X</orcidid><orcidid>https://orcid.org/0000-0001-7806-9903</orcidid><orcidid>https://orcid.org/0000-0003-1431-1777</orcidid><orcidid>https://orcid.org/0000-0002-7027-9436</orcidid><orcidid>https://orcid.org/0000-0002-3940-952X</orcidid><orcidid>https://orcid.org/0000-0003-4599-8487</orcidid><oa>free_for_read</oa></addata></record> |
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| title | Impact of Varicocele Repair on Assisted Reproductive Technique Outcomes in Infertile Men: A Systematic Review and Meta-Analysis |
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