Percutaneous Varicocele Embolization Versus Surgical Ligation For The Treatment Of Infertility: Changes In Seminal Parameters And Pregnancy Outcomes

Richard D., Shlansky-Goldberg, MD, Keith N. VanArsdalen, MD, Carolyn M. Rutter, PhD, Michael C. Soulen, MD, Ziv J. Haskal, MD, Richard A. Baum, MD, Douglas C.B. Redd, MD, Constantin Cope, MD, Michael J. Pentecost, MD

PURPOSE: To compare the success of percutaneous varicocele embolization to surgical ligation with regard to changes in semen characteristics and pregnancy outcome.

MATERIALS AND METHODS: Infertility records from 346 men who underwent correction of their varicocele for infertility (surgical ligation 149; embolization 197) were reviewed retrospectively. Preprocedural and postprocedural semen analyses and pregnancy outcomes were obtained with use of chart and telephone follow-up.

RESULTS: In men who successfully impregnated their partners, there were significant improvements in sperm density, percent total improvement, motility, and progression. Postprocedural (embolization vs surgery) percentage increases in seminal parameters were density, 156.8% versus 138.5%; total, 168.8% versus 157.9%; and motility, 2.7% versus 3.2%. The percent of individuals who had a change in sperm progression was 31% versus 41%. There was no statistical difference between the techniques based on t tests. The pregnancy rates were similar for the two groups, 39% and 34% for embolization and surgery, respectively.

CONCLUSION: There is no significant statistical difference in seminal values or pregnancy outcome between the two techniques.