Varicocele affects around 15% of males. Of these, 35% experience primary infertility, while 80% experience secondary infertility. Now, a 2024 study has investigated the impact of this disease on male fertility by assessing sperm parameters and DNA fragmentation index as well as the mean number of sperm DNA breaks and free DNA fragments in seminal plasma. In this article, we delve into the study’s findings and its suggestions for assessing fertility.
Varicocele and male fertility
Varicocele causes abnormal dilation, elongation, and twisting of the pampiniform plexus veins. It disrupts the normal testicular environment, leading to reduced oxygen levels, higher temperatures, and the buildup of metabolic byproducts. These changes can impact both sperm quality and quantity.
Because of their limited ability to repair DNA, sperm are particularly vulnerable to DNA damage. This vulnerability translates into sperm DNA fragmentation, a condition that impairs male fertility. In fact, the sixth edition of the WHO Laboratory Manual for the Examination and Processing of Human Semen emphasizes that the DNA fragmentation index (DFI) is a critical parameter for assessing male fertility.
Research has also shown that varicocele patients often experience heightened levels of reactive oxygen species (ROS), which can further compromise sperm DNA integrity. For these reasons, the study authors note that accurate assessment of sperm DNA health in varicocele patients is essential for diagnosing and treating infertility effectively.
The study, titled DNA Breakpoints and Free DNA fragments as Potential Predictors of Infertility, analyzed sperm samples from 42 varicocele patients and 22 healthy individuals. Fundamental sperm parameters were evaluated, including sperm concentration and vitality, and DNA Fragmentation Index (DFI) was examined using the Sperm Chromatin Structure Assay (SCSA) method. To gain deeper insights, researchers also measured the mean number of sperm DNA breaks (MDB) and the quantity of free DNA fragments in seminal plasma (fDFA) using the TDT-Strand Displacement Probe Technique.
Key Findings
The results showed that cases of varicocele-related infertility were linked to significantly elevated levels of DFI, MDB, and fDFA when compared to fertile individuals. The study found that assessing MDB and fDFA together provided a more accurate prediction of fertility potential than evaluating these markers individually or relying solely on the DFI. These findings continue to show the importance of a comprehensive approach to fertility assessment in men with varicocele. Still, as noted by the study authors, while these findings suggest a potential role for MDB and fDFA as predictors of male fertility, further rigorous studies are needed to validate their application in varicocele-related male infertility.
Conclusion
Varicocele is a common condition and is a significant contributor to male infertility. This latest study provides further insight into the condition, emphasizing the importance of a combined evaluation of MDB and fDFA for a better understanding of fertility potential in varicocele cases.
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