Microsurgical Varicocelectomy is Associated with Reduced Seminal ADAM10 and ADAM17 Concentrations: A Prospective Cohort Study

Objective: Varicocele is one of the most common surgically correctable causes of male infertility, with its pathophysiology increasingly linked to oxidative stress and chronic local inflammation. A Disintegrin and Metalloproteinase 10 (ADAM10) and ADAM17 are redox-sensitive membrane sheddases involved in the regulation of inflammatory and reproductive pathways, yet their clinical relevance in varicocele remains unclear. This study aimed to evaluate the effect of microsurgical varicocelectomy on seminal plasma ADAM10 and ADAM17 concentrations in men with clinically high-grade varicocele.Material and Methods: In this prospective pre–post study, thirty infertile men with Grade 3 left-sided varicoceles underwent microsurgical inguinal varicocelectomy and were reassessed six months postoperatively. Seminal plasma ADAM10 and ADAM17 concentrations were quantified by human-specific sandwich ELISA. Within-subject comparisons were performed using the Wilcoxon signed-rank test.Results: Both biomarkers showed a statistically significant postoperative decline. Seminal ADAM10 decreased from a preoperative median of 8.75 ng/mL (Q1–Q3: 6.80–10.23) to 7.83 ng/mL (Q1–Q3: 5.51–9.28) after surgery (Z = 2.14; p = .031; r = .39), with a reduction observed in 22 of 30 patients (73.3%). The postoperative decrease was more pronounced for ADAM17, which declined from 1.10 ng/mL (Q1–Q3: 0.51–1.38) to 0.50 ng/mL (Q1–Q3: 0.33–0.65) (Z = 3.04; p = .002; r = .56), with a reduction observed in 21 of 30 patients (70.0%).Conclusion: Microsurgical varicocelectomy was associated with a significant reduction in seminal plasma ADAM10 and, more prominently, ADAM17 concentrations, suggesting attenuation of the local oxidative–inflammatory burden following surgical correction. Seminal ADAM10 and ADAM17 may be considered exploratory indicators reflecting molecular remodeling in the seminal microenvironment following varicocelectomy.