정계정맥류 수술후의 임신성공율

Abstract

Varicocele is found in 8-20% of male population and comprises the most common etiology of male infertility. Abnormalities in sperm concentration, motility, and morphology are observed on 65 to 75% of varicocele patients. Improvements of such parameters are seen in 50 - 80% after surgical correction of varicocele, and fertility is achieved in 30 -40% of cases. We evaluated the results of surgical correction of varicocele in both infertile and non-infertile patients. The effects of varicocele and subsequent correction on semen parameters and pregnancy were also reviewed. From September 1987 to December 1995, 254 patients with varicocele were surgically corrected. Semen analysis were performed in 229 patients, revealing abnormalities in 153 (66.8%) patients. Degree of abnormalities was correlated with the grade of varicocele and presence of infertility (79.8%). Improvement of postoperative semen was observed in 112 (73.2%) of 153 patients with abnormal preoperative semen profiles. Improvement was not correlated with grade of varicocele or age, but significantly correlated with fertility status. Postoperative sperm concentration, morphology, and motility were significantly improved in grade II and III varicocele. Sperm motility was improved when correction were performed under 30 years of age. Pregnancy was confirmed in 27 of 88 (30.7%) of infertile patients, and fertility rate was correlated with preoperative sperm concentration and motility, but not correlated with varicocele grade and sperm morphology. Higher pregnancy rate was observed if sperm concentration >=40 X 106/ml, normal morphology >= 60%, and motility >=60% on the postoperative semen. In conclusion, varicocele patients with infertility are affected by grade, age, and surgical correction. Thus early diagnosis and treatment should be offered to all patients with varicocele with infertility