Does the Type of Infertility Affect Varicocelectomy Efficacy?

Background: The aim of the study was to compare varicocelectomy efficacy in men with primary (PI) and secondary infertility (SI). Materials and methods: Men suffering from PI (n=22) and SI (n=28) and having varicocelectomy in the period of from January 2021 to December 2022 at Republican Specialized Scientific-Practical Medical Center of Urology were included in the study. Semen parameters before and after varicocelectomy were analyzed according to WHO 2010 Manual. Results: Analysis revealed that the mean age of patients of the group I was significantly lower (p <0.001) and duration of infertility was accurately shorter (p <0.01) than those of group II. Main semen parameters increased significantly in group I (e.g., sperm concentration increased by 50%, from 62,2±8,7 to 93,5±10,0 M/ml and total motile sperm count increased by 113%, from 76,7±17,1 to 163,4±27,8 M p<0.05), while in group II only % of progressive motile sperm increased significantly (by 107%, from 13,5±2,6 to 28,0±5,2% p<0.05). We identified significant difference in varicocelectomy efficacy between group I and group II in change of total motile sperm count (by 113% vs. 74% respectively, p<0.01). We also revealed discrepancy between groups in correlation ratio (r) between initial and post-surgical % of progressive motile sperm. Conclusions: The mean age and duration of infertility of patients with SI was greater and longer respectively than those of in patients with PI. Varicocelectomy resulted in significant improvement of main semen parameters in patients with PI. In patients with SI varicocelectomy resulted in significant improvement of only % of progressive motile sperm. Advanced paternal age and long infertility duration may affect negatively varicocelectomy efficacy.