Efficacy Of Varicocele Repair On Sperm DNA Integrity And Seminal Oxidative Stress Markers
Keywords:
Varicocele; Varicocelectomy; Sperm DNA fragmentation; Oxidative stress; SOD; MDA; Male infertility.Abstract
Background: Varicocele is the most common correctable cause of male infertility and is often associated with oxidative stress and sperm DNA damage. Sperm DNA fragmentation (SDF), superoxide dismutase (SOD), and malondialdehyde (MDA) are important biomarkers that reflect sperm oxidative balance and functional integrity.
Objective: To evaluate the effect of varicocelectomy on sperm DNA fragmentation, seminal oxidative stress markers (SOD and MDA), and semen quality parameters in infertile men with clinical varicocele.
Patients and Methods: This prospective comparative study included 50 infertile men (mean age 33.1 ± 1.4 years) with grade II–III palpable varicocele. All patients underwent preoperative and 3-month postoperative assessments including semen analysis, sperm DNA fragmentation index (DFI; COMET assay), seminal plasma levels of SOD and MDA, α-glucosidase activity, and acrosin activity index.
Results: Three months after varicocelectomy, significant improvements were observed in sperm concentration (24.1 → 33.8 × 10⁶/mL; +40%), progressive motility (21.5 → 36.7%; +70%), and normal morphology (7.0 → 17.3%; +147%) (p < 0.001). Mean DFI decreased from 65.3 ± 20.7% to 49.3 ± 17.4% (-24.5%), while MDA decreased from 5.93 to 3.85 nmol/mL (-35.1%). Conversely, mean SOD activity increased from 8.99 ± 3.16 to 12.29 ± 5.77 U/mL (+36.7%) (p < 0.001). SDF correlated positively with MDA and negatively with SOD and semen parameters.
Conclusion: Varicocelectomy significantly improves sperm DNA integrity, oxidative stress markers, and semen quality in infertile men with clinical varicocele. SDF may serve as a sensitive molecular indicator of varicocele-related male infertility and response to surgical correction.
