Preoperative follicle-stimulating hormone: A factor associated with semen parameter improvement after microscopic subinguinal varicocelectomy

  • Vinayak Madhusoodanan University of Miami Miller School of Medicine https://orcid.org/0000-0002-5499-7876
  • Ruben Blachman-Braun University of Miami Miller School of Medicine, Miami, FL, USA.
  • Premal Patel Department of Urology, University of Miami Miller School of Medicine, Miami, FL, USA.
  • Lunan Ji Department of Urology, University of Miami Miller School of Medicine, Miami, FL, USA.
  • Thomas A. Masterson Department of Urology, University of Miami Miller School of Medicine, Miami, FL, USA.
  • Michael Owyong University of Miami Miller School of Medicine, Miami, FL, USA
  • Aubrey Greer University of Miami Miller School of Medicine, Miami, FL, USA.
  • Ranjith Ramasamy Department of Urology, University of Miami Miller School of Medicine, Miami, FL, USA.
Keywords: Follicle stimulating hormone, varicocele, varicocelectomy, semen, FSH

Abstract

Introduction: Currently, there exists no serum biomarker to predict patients likely to benefit from varicocelectomy. The purpose of this study was to assess the association between baseline follicle-stimulating hormone (FSH) and semen parameter changes after subinguinal microscopic varicocelectomy.

Methods: We retrospectively reviewed all men who underwent microscopic subinguinal varicocelectomy between August 2015 and October 2018. Pre- and postoperative semen analyses were stratified per total motile sperm count (TMSC): TMSC <5, 5–9, and >9 million (based on TMSC required for in vitro fertilization, intrauterine insemination [IUI], and natural conception, respectively). Then, variables were analyzed to determine the correlation with postoperative TMSC values and upgrade in TMSC category.

Results: Among the 66 men analyzed, 55 (83.3%) and 11 (16.7%) had a preoperative TMSC of <5 million and 5–9 million, respectively. A total of 33 (50%) patients upgraded in TMSC category, 26 of them achieving levels corresponding to natural conception and seven achieving those of IUI. Additionally, a significant correlation was observed between postoperative TMSC and preoperative TMSC (r=0.528; p<0.001), and preoperative FSH (r=-0.314; p=0.010). A lower preoperative FSH (odds ratio [OR] 0.82; 95% confidence interval [CI] 0.68–0.98; p=0.028) and a higher preoperative TMSC (OR 1.37; 95% CI 1.06–1.76; p=0.015) were associated with upgrade in TMSC category.

Conclusions: Lower preoperative FSH and higher TMSC are associated with improvement in TMSC category after varicocelectomy, although small sample size limited the study. FSH can be useful to identify men who are most likely to benefit from varicocele repair.

Author Biographies

Vinayak Madhusoodanan, University of Miami Miller School of Medicine

MS4

Premal Patel, Department of Urology, University of Miami Miller School of Medicine, Miami, FL, USA.

Fellow, Male Reproductive Medicine and Andrology

Lunan Ji, Department of Urology, University of Miami Miller School of Medicine, Miami, FL, USA.

PGY5

Thomas A. Masterson, Department of Urology, University of Miami Miller School of Medicine, Miami, FL, USA.

PGY5

Michael Owyong, University of Miami Miller School of Medicine, Miami, FL, USA

MS4

Aubrey Greer, University of Miami Miller School of Medicine, Miami, FL, USA.

MS3

Ranjith Ramasamy, Department of Urology, University of Miami Miller School of Medicine, Miami, FL, USA.

Assistant Professor of Clinical Urology, Director of Male Reproductive Medicine and Andrology Fellowship

Published
2019-06-17
How to Cite
Madhusoodanan, V., Blachman-Braun, R., Patel, P., Ji, L., Masterson, T. A., Owyong, M., Greer, A., & Ramasamy, R. (2019). Preoperative follicle-stimulating hormone: A factor associated with semen parameter improvement after microscopic subinguinal varicocelectomy. Canadian Urological Association Journal, 14(1), E27-31. https://doi.org/10.5489/cuaj.5910
Section
Original Research