(811) Influence of Body Mass Index on Semen Quality Following Varicocele Repair

Introduction It is well known that in the face of an abnormal sperm count, varicocele treatment can improve sperm parameters. However, when this is recognised in men who are obese, is the effect of varicocle treatment as effective? Objective We set out to investigate whether a higher BMI influences the efficacy of varicocele treatment in improving semen parameters and negates the need for varicocele treatment Methods A retrospective study was carried out on consecutive adult male patients who underwent varicocele embolisation (VE) or microsurgical varicocelectomy (MSV) between 2017 and 2025 at a single institution. Men who had semen analysis before treatment, a repeat analysis at least 3 months after treatment and recorded BMI were included. Data including previous treatment, clinical and radiological varicocele grade, and pre-treatment testosterone were collected. BMI was analysed both as a linear and categorical variable (healthy weight, overweight and obese) Results Seventy-seven patients were included in the final analysis, with a median BMI of 25.4 (IQR 18.7–32.2). 31 patients were of healthy weight (BMI <25), 22 were overweight (BMI 25–30) and 31 were obese (BMI >30). Median age was 36 and median pre-treatment testosterone was 15.7 (IQR 9.0–22.3). Overall, the median improvement of total motile sperm count (TMSC) was 27.0 million per ejaculate (p = 0.025), indicating a significant post-treatment increase. A linear regression of ΔTMSC on BMI showed a negative but non-significant association between BMI and improvement in TMSC (b = –0.115, p = 0.916). When stratified by BMI category, the association remained non-significant for both BMI ≤30 (b = –0.115, p = 0.916) and BMI >30 (b = –0.614, p = 0.592). The Kruskal–Wallis test comparing ΔTMSC across BMI categories (healthy, overweight, obese) also showed no significant difference (H = 0.309, df = 2, p = 0.857). There was no significant difference in change in post-operative TMSC between those with and without hypogonadism (Z = –0.794, p = 0.427). Conclusions In this single-institutional cohort, improvement in semen parameters after varicocele embolisation or MSV was not impacted by a BMI. Patients with BMI >30 also benefit from varicocele repair. Disclosure No