Sarcouncil Journal of Medical Sciences

Abstract: Purpose: The study was a prospective randomized controlled trial, which compared the use of scrotal Doppler ultrasound and detection and grading of varicoceles, and the efficacy of micro-surgery varicocelectomy in improving the semen quality of 97 from Iraq infertile men between age 25-40 with primary infertility and an ultrasound-proven varicoceles where The main outcomes were the changes in sperm concentration, motility, and morphology; 25% improvement in power ( 25 percent, 90 percent ). Paired t-tests, ANOVA, and logistic regression (SPSS v27) were used to analyze the data. Findings: There were no differences between intergroups (age 32.4±4.2 vs. 33.1±4.5 years, p=0.42; BMI 24.1±3.2 vs. 24.8±3.5 kg/m 2, p=0.28). Significant improvements were achieved with surgical intervention: concentration +76.8% (18.5±8.2 to 32.7±10.4 x10 6 to/mL, p<0.001), motility +28.0%(38.2±12.1 to 48.9±11.3% to/mL, p<0.01), morphology +50.8%(12.4+4.3 to 18.7+5.1 to/m The Grade 2-3 cases were best (responder rates 67-78%), testicular volume +20.3% (p<0.01) and pregnancy rate 28.4 vs. 14.3 (OR 2.3, 95% CI 1.4-3.8). The rate of adverse events was low (hydrocele 3.2%). Conclusions: Varicocelectomy of the ultrasound-guided modality is highly beneficial in improving the semen parameters and fertility, especially in moderate-severe grades, which beats observation and arguments in its all-time usage in oligoasthenoteratozoospermia as per clinical guidelines.