SynthesisFrontiers in endocrinology2026
Effect of varicocele surgical repair on antisperm antibody positivity rate in patients with clinical varicocele: a systematic review and meta-analysis.
Synthesis in Frontiers in endocrinology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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4 authors.
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Abstract
Background: Varicocele is a common correctable cause of male infertility, and antisperm antibodies (ASA) have been detected at varying rates in affected men. However, the effect of varicocele repair on ASA positivity remains controversial, and no meta-analysis has specifically quantified this outcome in men with clinical varicocele. Methods: We systematically searched PubMed, Web of Science, Embase, Cochrane Library, CNKI, VIP, Wanfang, and SinoMed up to April 30, 2026. Before-after studies reporting ASA positivity rates or ASA levels in men with clinical varicocele were included. Pooled risk ratios (RRs) with 95% confidence intervals (CIs) were calculated using a random-effects model. Subgroup analyses were performed by surgical technique. Sensitivity analyses and publication bias assessment were conducted. Results: Ten studies (13 comparisons, 722 patients) were included in the RR analysis. Varicocele repair was associated with a lower ASA positivity rate compared with preoperative levels (RR = 0.42; 95% CI: 0.35-0.52; P < 0.00001). Subgroup analysis according to surgical technique showed lower postoperative ASA positivity rates in the microsurgical, laparoscopic, and high ligation groups, with the lowest pooled RR observed in the microsurgical subgroup (RR = 0.32). A significant subgroup difference was observed ( Conclusion: Varicocele repair was associated with reduced ASA positivity among men with clinical varicocele, with the lowest pooled RR observed in the microsurgical subgroup. The results are robust across sensitivity analyses. These findings suggest that varicocele repair may influence immune-related alterations reflected by ASA positivity; however, the clinical utility of ASA testing for surgical decision-making remains uncertain.
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