Case Report
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World J Clin Cases. Apr 16, 2014; 2(4): 94-96
Published online Apr 16, 2014. doi: 10.12998/wjcc.v2.i4.94
Varicocele repair in severe oligozoospermia: A case report of post-operative azoospermia
Marco Milone, Mario Musella, Miguel Emilio Sosa Fernandez, Paola Maietta, Annarita Sasso, Loredana Maria Sosa Fernandez, Laura Virginia Sosa Fernandez, Francesco Milone
Marco Milone, Mario Musella, Paola Maietta, Francesco Milone, Department of Advanced Biomedical Science, University of Naples “Federico II”, 80131 Naples, Italy
Miguel Emilio Sosa Fernandez, Annarita Sasso, Loredana Maria Sosa Fernandez, Laura Virginia Sosa Fernandez, Embryos, IVF Center in Battipaglia, 84100 Salerno, Italy
Author contributions: Milone M and Musella M contributed to the conception and design; Sosa Fernandez ME contributed to drafting the article and revising it critically for important intellectual content; Maietta P, Sasso A, Sosa Fernandez LM and Sosa Fernandez LV contributed to the acquisition, analysis and interpretation of data; Milone F contributed to the final approval of the version to be published.
Correspondence to: Marco Milone, MD, Department of Advanced Biomedical Science, University of Naples “Federico II”, Via Pansini 5, 80131 Naples, Italy. milone.marco@alice.it
Telephone: +39-81-7463067 Fax: +39-81-7462896
Received: October 31, 2013
Revised: February 10, 2014
Accepted: February 20, 2014
Published online: April 16, 2014
Processing time: 161 Days and 16.3 Hours
Abstract

Varicocele has been implicated as a cause in 35%-50% of patients with primary infertility and up to 81% of men with secondary infertility. Although a large number of reports have shown improvement in the semen parameters after correction of varicocele, other studies have suggested no benefit. We report the first case of azoospermia after surgery in a young infertile male patient with left-sided varicocele and severe oligozoospermia undergoing laparoscopic varicocelectomy. A pregnancy was only achieved with assisted reproductive technology because semen cryopreservation was performed before surgery. In the light of the above, the deterioration of sperm count after varicocele repair in patients with severe oligozoospermia could be due to irreversible impairment of spermatogenesis of such patients, together with the possible temporary damage of the surgical repair. This possible complication could therefore turn the severe oligozoospermia into an indication to perform cryopreservation before surgery, on both clinical and medico-legal grounds. Further research is needed before drawing definitive conclusions regarding the management of varicocele-related severe oligozoospermia.

Keywords: Varicocele; Fertility; Semen; Cryopreservation; Oligozoospermia

Core tip: We report a case of deterioration of sperm count after varicocele repair in a patient with severe oligozoospermia. This possible complication could therefore turn severe oligozoospermia into an indication to perform cryopreservation before surgery, on both clinical and medico-legal grounds.