Effects of Varicocelectomy Surgery on Sperm Morphology and Male Fertility

• Published in: Pakistan journal of medicine and dentistry Vol. 14; no. 3
• Main Authors: Jan, Mir Abid, Fiaz, Shaukat, Khan, Ismail, Rahman, Syed Zia Ur, Rehman, Khalil Ur
• Format: Journal Article
• Language: English
• Published: ziauddin University 21.07.2025
• Subjects: Infertility; Semen Analysis; Sperm Morphology; Varicocele; Varicocelectomy
• ISSN: 2313-7371; 2308-2593
• DOI: 10.36283/ziun-pjmd14-3/055

Background: Varicocele is associated with impaired semen parameters and reduced spermatogenesis. Microsurgical varicocelectomy has been shown to improve testicular function. This study aimed to assess its effect on sperm morphology. Methods: A prospective observational study was conducted on 112 infertile males with Grade II or III clinical varicocele at the Institute of Kidney Diseases (IKD), MTI-Hayatabad Medical Complex, Peshawar, from September 1, 2024, to February 28, 2025. Non-probability consecutive sampling was used. Semen analysis was performed before surgery and repeated six months postoperatively. Outcome variables included sperm morphology, concentration (million/mL), and semen volume (mL). Data were analyzed using SPSS version 26.0. Paired sample t-tests assessed changes, with subgroup analysis by varicocele grade, laterality, age, and infertility duration. A p-value < 0.05 was considered significant. Results: Mean age was 31.8 ± 5.4 years; mean infertility duration was 3.3 ± 1.8 years. Most patients (68.7%) had unilateral varicocele; Grade III was most common (60.7%). Six months post-surgery, semen parameters improved significantly: sperm morphology increased from 2.2 ± 1.3 to 5.7 ± 1.8 normal forms, concentration from 12.6 to 22.5 million/mL, and volume from 2.5 to 3.0 mL (all p < 0.001). Conclusion: Microsurgical varicocelectomy significantly improves semen quality in infertile males with clinical varicocele, especially in younger patients with shorter infertility duration.