ArticleThe world journal of men's health2026
The Effects of Varicocele Repair on Testicular Sperm Retrieval, Sperm Recovery in the Ejaculate and Clinical Pregnancy Rates in Non-Obstructive Azoospermic Men with Clinical Varicocele: A Systematic Review and Meta-Analysis.
Article in The world journal of men's health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Live Birth Rates After Varicocele Embolization in Patients After Failed In Vitro Fertilization With Intracytoplasmic Sperm Injection.Andrology · 2026Article
- Is Varicocele Truly Unilateral? Contralateral Involvement and Bilateral Testicular Effects in Male Infertility: A Narrative Review.Journal of personalized medicine · 2026Review
- Seminal-Plasma Molecular Biomarkers as a Liquid Biopsy of Testicular Function: Toward AI-Ready Sperm-Retrieval Prediction in Non-Obstructive Azoospermia.International journal of molecular sciences · 2026Review
- Varicocelectomy Restores Spermatogenesis in Fontan-Associated Varicocele: A Two-Case Series.IJU case reports · 2026Article
- Astragaloside IV attenuates ferroptosis-related testicular injury in rats with experimental varicocele.Frontiers in pharmacology · 2026Article
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28 authors.
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Abstract
purposeThe role of varicocele repair (VR) in infertile men with non-obstructive azoospermia (NOA) and varicocele is controversial in the current guidelines, despite available studies. This study aims to assess the impact of VR on testicular sperm retrieval, sperm recovery from the ejaculate, and clinical pregnancy rates in infertile men with NOA and clinical varicocele through a systematic review and meta-analysis (SRMA) of controlled studies. MATERIALS AND
methodsA systematic literature search was conducted using the Scopus and PubMed databases up to November 2023. Among the 1,847 articles retrieved, five observational controlled studies comparing reproductive outcomes between infertile men with NOA and clinical varicocele who underwent VR, and a control group that received no treatment, met the inclusion criteria for this SRMA.
resultsThe selected studies included 269 men with NOA who underwent VR before the testicular sperm extraction (TESE) procedure and 364 men who did not undergo VR. The pooled estimate demonstrated a significantly higher odds ratio (OR) of 2.17 (95% confidence interval [95% CI]: 1.17-4.01, p=0.01) for surgical sperm retrieval in the VR group. VR significantly increased the likelihood of sperm appearance in the ejaculate, with an OR of 7.8 (95% CI: 3.59-16.94, p<0.001). Besides, VR provided a significantly greater clinical pregnancy rate with intracytoplasmic sperm injection (ICSI) compared to non-operated men (OR: 2.18, 95% CI: 1.03-4.60; p=0.04).
conclusionsThis is the first SRMA, consisting of only controlled studies, to demonstrate that VR performed prior to TESE in men with NOA significantly improves sperm production as reflected in the spontaneous appearance of sperm in the semen and higher odds of surgical sperm retrieval and clinical pregnancy compared with non-operated men. Thus, these findings highlight the potentially beneficial impact of VR in men with NOA and clinical varicocele.
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