To Study the Outcome of Varicocele Ligation in Improving the Semen Parameters in Cases Undergoing Varicocele Surgery

Background: Varicocele is one of the most common surgically correctable causes of male infertility and is frequently associated with abnormal semen parameters and impaired spermatogenesis. Despite decades of research, controversy persists regarding patient selection and the magnitude of benefit following varicocele ligation. Semen parameters including sperm concentration, motility, morphology, and vitality remain the cornerstone for assessing spermatogenic function and treatment response.

Aim: To study the outcome of varicocele ligation in improving semen parameters in cases undergoing varicocele surgery.

Materials and Methods: This prospective observational study was conducted in 50 men aged 18–42 years with clinically palpable unilateral or bilateral varicocele who underwent inguinal varicocele ligation. Baseline clinical evaluation, scrotal ultrasonography, hormonal profile, and semen analysis were performed prior to surgery. Semen parameters were reassessed three months postoperatively using the same methodology. Preoperative and postoperative values were compared to evaluate changes in sperm concentration, motility, morphology, semen volume, vitality, and testosterone levels. Appropriate statistical tests were applied, and p-values <0.05 were considered significant.

Results: The mean age of participants was 28.9 ± 5.1 years, and primary infertility constituted 72% of cases. Baseline semen analysis demonstrated oligozoospermia, asthenozoospermia, and teratozoospermia in a substantial proportion of patients. After varicocele ligation, significant improvements were observed in sperm concentration (+39.0%, p=0.002), total sperm count (+45.2%, p=0.004), total motility (+33.7%, p<0.001), progressive motility (+48.3%, p<0.001), normal morphology (+30.2%, p=0.019), and sperm vitality (+7.4%, p=0.042). Serum testosterone levels also increased significantly (p=0.018). Overall, marked or moderate improvement in semen parameters was seen in 68.8% of patients. Normozoospermia increased from 8.3% preoperatively to 22.9% postoperatively. Postoperative complications were mostly minor, with scrotal edema being the most common (18%).

Conclusion: Varicocele ligation results in significant improvement in semen parameters and hormonal profile in a majority of patients and represents an effective treatment option for selected infertile men with varicocele.