Multimodal biomarker profiling in varicocele predicts surgical recovery

AIMS: Varicocele (VC) remains a leading correctable cause of male infertility, yet standardized multimodal biomarkers are lacking for clinical stratification and outcome prediction. PATIENTS AND METHODS: This prospective observational study enrolled 131 primary VC patients and 20 healthy controls, evaluating semen parameters, sperm DNA fragmentation index (DFI), testicular shear wave elastography (SWE), hormonal profiles, and inflammatory/metabolic markers. RESULTS: = 0.011). Preoperative DFI (OR =1.045), abnormal sperm morphology rate (OR =1.604), and sperm PM (OR =0.951) independently predicted complete semen parameter recovery at 3 months (AUC = 0.863, sensitivity 67.9%, specificity 89.5%). CONCLUSION: An integrated multimodal framework incorporating imaging, molecular, and functional biomarkers facilitates prognostic stratification and personalized management of varicocele-associated infertility.