Predictive Factors of Sperm Recovery in Azoospermic Patient Post Varicocele Ligation (December 2020 to December 2021)

Background: Varicocele, an abnormal enlargement of the pampiniform venous plexus in the scrotum, affects around 15% of men and 40% of fertility-problem men. It is believed to impair sperm production. This study aims to evaluate the frequency and predictive factors of successful sperm recovery in azoospermic patients post varicocele ligation. Methodology: A cross-sectional hospital-based study, was conducted in Ibn Sina Specialized Hospital and Hawa Infertility Center, within the period from December 2020 to December 2021, included 70 infertile patients with NOA and palpable varicocele on their physical examination, data was collected through direct interview closed ended questionnaire, analyzed by computer using Statistical Package For social science (SPSS) version 25.0. Results: Seventy patients were included in this study with mean age of 36.4±2.5 years. Mean infertility duration was 4.15±2.04 years. Body mass index was normal in over half of patients (52.9%), 40 patient (57.1%) had varicocele Grade III, followed by 30 (42.9%) had varicocele Grade II, most of patients 44(62.9%) underwent unilateral varicocelectomy. histopathology showed sertoli only cell in 11(29.7%), maturation arrest 14(37.8%), and hypospermatogensis in 12(32.4%). Semen analysis /TESE in 3-6 months post varicocele ligation was positive in 27(38.6%), and negative in 43(61.4%). patients age (P value =0.017) duration of infertility (P value =0.012). BMI (P value=0.007) Grade of varicocele. (P value=0.006) were significant predictors of successful sperm recovery after varicocelectomy. Conclusion: Varicocelectomy is an acceptable modality of treatment for non-obstructive azoospermic patients with clinically palable varicocele, especially in young age , non obese, with hyopspermatogensis in histopathology, a higher grade of varicocele, and a shorter duration of infertility, which showed a high rate of sperm recovery.