ArticleThe world journal of men's health2024
Effects of Varicocele Repair on Sperm DNA Fragmentation and Seminal Malondialdehyde Levels in Infertile Men with Clinical Varicocele: A Systematic Review and Meta-Analysis.
Article in The world journal of men's health, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 2 of them syntheses that pooled it.
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Who cites it
28 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- The first Australian evidence-based guidelines on male infertility.The Medical journal of Australia · 2025Guideline
- Surgical efficacy and predictors of outcome in varicocelectomy: a meta-analysis of multivariable studies.World journal of urology · 2025Pooled it
- Live Birth Rates After Varicocele Embolization in Patients After Failed In Vitro Fertilization With Intracytoplasmic Sperm Injection.Andrology · 2026Article
- Re-Imagining Male Infertility Guidelines through the Global Andrology Forum.The world journal of men's health · 2026Article
- The Therapeutic Effects ofHealth science reports · 2026Article
- Is Varicocele Truly Unilateral? Contralateral Involvement and Bilateral Testicular Effects in Male Infertility: A Narrative Review.Journal of personalized medicine · 2026Review
- Varicocelectomy in men with varicocele-associated infertility: a narrative review of semen quality and reproductive outcomes.Translational andrology and urology · 2026Review
- Adipose-derived stem cells-conditioned medium (ADMSCs-CM) improves testicular function and sperm DNA damage via Nrf2 antioxidant signaling pathways in rat unilateral varicocele.Stem cell research & therapy · 2026Article
- Impact of Varicocele on Pregnancy and Live Birth Outcomes in Men with Clinical Varicocele: Systematic Review of Controlled Studies.The world journal of men's health · 2026Article
- Oxidative Stress, Sperm DNA Fragmentation, or Both? Optimizing Test Selection in Male Infertility Evaluation.Antioxidants (Basel, Switzerland) · 2026Review
- Does the Quality and Readability of Information Related to Varicocele Obtained from ChatGPT 4.0 Remain Consistent Across Different Models of Inquiry?The world journal of men's health · 2026Article
- Association of vitamin D, oxidative stress markers, and hormonal factors with male infertility: a case-control study in Pakistan.Turkish journal of medical sciences · 2026Article
- Evaluating Sperm DNA Damage: When and Why It Adds to the Management of the Infertile Man.Advances in experimental medicine and biology · 2026Review
- Global Andrology Forum Clinical Guidelines on the Relevance of Sperm DNA Fragmentation in Reproductive Medicine.The world journal of men's health · 2026Article
- Relative Sertoli-cell FSH hyporesponsiveness as a potential contributor to sperm DNA fragmentation: a hypothesis-driven narrative review and proposal of the FERTILE framework.Frontiers in urology · 2026Article
- Global Andrology Forum (GAF) Clinical Guidelines on the Management of Infertile Men with Varicocele.The world journal of men's health · 2026Article
- The role of sperm DNA fragmentation in reproduction: a SWOT analysis.Journal of assisted reproduction and genetics · 2025Review
- Comparison of DNA fragmentation index and fertility rate after unilateral and bilateral microsurgical varicocelectomy.European journal of translational myology · 2025Article
- Recent Guidelines and Perspectives for Varicocele: A Clinical Consensus and Recommendations from the Korean Society for Sexual Medicine and Andrology.The world journal of men's health · 2025Review
- Pathophysiological effects of hypoxia on testis function and spermatogenesis.Nature reviews. Urology · 2025Review
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Authors and funding
43 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeVaricoceles can be a source of elevated seminal oxidative stress (OS) and sperm DNA fragmentation (SDF). However, it remains unclear whether varicocele repair (VR) could reduce these parameters. This systematic review and meta-analysis (SRMA) aims to investigate the impact of VR on SDF and seminal malondialdehyde (MDA). MATERIALS AND
methodsA literature search was performed in Scopus, PubMed, Ovid, Embase, and Cochrane databases. This SRMA included randomized controlled trials and observational studies reporting the pre- and postoperative levels of SDF and seminal OS in infertile men with clinical varicocele that underwent VR. Subgroup analyses included techniques of VR and SDF testing. The effect size was expressed as standardized mean difference (SMD).
resultsOut of 1,632 abstracts assessed for eligibility, 29 studies with 1,491 infertile men were included. The analysis showed a significant reduction in SDF after VR, compared to preoperative values (SMD -1.125, 95% confidence interval [CI] -1.410, -0.840; p<0.0001) with high inter-study heterogeneity (I²=90.965%). Reduction in SDF was evident with microsurgical technique and non-microsurgical inguinal approaches (SMD -1.014, 95% CI -1.263, -0.765; p<0.0001, and SMD -1.495, 95% CI -2.116, -0.873; p<0.0001), respectively. Reduction in SDF was significant irrespective of testing was done by sperm chromatin dispersion (SMD -2.197, 95% CI -3.187, -1.207; p<0.0001), sperm chromatin structure assay (SMD -0.857, 95% CI -1.156, -0.559; p<0.0001) or TUNEL (SMD -1.599, 95% CI -2.478, -0.719; p<0.0001). A significant decrease in seminal MDA levels was observed following VR (SMD -2.450, 95% CI -3.903 to -0.997, p=0.001) with high inter-study heterogeneity (I²=93.7%).
conclusionsUsing pre- and post-intervention data, this SRMA indicates a significant reduction in SDF and seminal MDA levels in infertile men with clinical varicocele treated with VR. These findings may have important implications for the future management of this selected group of infertile patients.
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