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  1. Article: Impact of Varicocele on Testicular Oxidative Stress and Sperm Parameters in Experimental Animals: A Systematic Review and Meta-Analysis.

    Russo, Giorgio Ivan / Saleh, Ramadan / Finocchi, Federica / Juma, Almas Ramadhani / Durairajanayagam, Damayanthi / Kahraman, Oguzhan / Söğütdelen, Emrullah / Sokolakis, Ioannis / Vishwakarma, Ranjit B / Bahar, Fahmi / Harraz, Ahmed M / Kavoussi, Parviz / Atmoko, Widi / Chung, Eric / Kumar, Naveen / Zohdy, Wael / Rambhatla, Amarnath / Arafa, Mohamed / Phuoc, Nguyen Ho Vinh /
    Salvio, Gianmaria / Calogero, Aldo E / Toprak, Tuncay / Pinggera, Germar-Michael / Cannarella, Rossella / Colpi, Giovanni / Abdel-Meguid Hamoda, Taha Abo-Almagd / Shah, Rupin / Agarwal, Ashok

    The world journal of men's health

    2024  

    Abstract: Purpose: Varicocele has been associated with high seminal oxidative stress (OS), impaired semen quality, and reduced male fertility potential. However, the exact mechanism(s) underlying the development of varicocele-mediated infertility and the cause- ... ...

    Abstract Purpose: Varicocele has been associated with high seminal oxidative stress (OS), impaired semen quality, and reduced male fertility potential. However, the exact mechanism(s) underlying the development of varicocele-mediated infertility and the cause-effect relationship between varicocele and testicular dysfunction are not fully understood. The aim of this systematic review and meta-analysis (SRMA) is to investigate the impact of varicocele on testicular OS markers and sperm parameters in experimental animals with varicocele as compared to animals without varicocele.
    Materials and methods: A literature search was performed using the Scopus and PubMed databases on studies that investigated testicular OS markers and sperm parameters in animals with varicocele. The primary outcomes included malondialdehyde (MDA) (nmol/mg) levels whereas the secondary outcomes included total sperm count (×10
    Results: Out of 76 identified articles, 6 studies on rats were included in the meta-analysis. The analysis showed a significant increase of MDA (SMD: 15.61 [1.93, 29.29]; p=0.03) in rats with varicocele vs. controls. We also observed a significant decrease in total sperm count (SMD: -17.45 [-28.97, -5.93]; p<0.01), sperm vitality (SMD: -16.41 [-26.30, -6.52]; p<0.01), total sperm motility (SMD: -17.67 [-24.90, -10.44]; p<0.01), and a significant increase of SDF (SMD: 7.41 [1.23, 13.59]; p=0.02), in rats with varicocele vs. controls. The quality of the included studies was ranked as high.
    Conclusions: This SRMA indicates a significant increase in levels of testicular MDA and SDF and a reduction of sperm quality in experimental animals with varicocele. These findings support the potential role of testicular OS in the development of varicocele-induced testicular damage.
    Language English
    Publishing date 2024-02-07
    Publishing country Korea (South)
    Document type Journal Article
    ZDB-ID 2719786-4
    ISSN 2287-4690 ; 2287-4208
    ISSN (online) 2287-4690
    ISSN 2287-4208
    DOI 10.5534/wjmh.230260
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Effects of Varicocele Repair on Sperm DNA Fragmentation and Seminal Malondialdehyde Levels in Infertile Men with Clinical Varicocele: A Systematic Review and Meta-Analysis.

    Cannarella, Rossella / Shah, Rupin / Saleh, Ramadan / Boitrelle, Florence / Hamoda, Taha Abo-Almagd Abdel-Meguid / Singh, Rajender / Salvio, Gianmaria / Toprak, Tuncay / Falcone, Marco / Gul, Murat / Dimitriadis, Fotios / Rambhatla, Amarnath / Russo, Giorgio I / Ko, Edmund / Zini, Armand / Kavoussi, Parviz / Phuoc, Nguyen Ho Vinh / Kandil, Hussein / Ghayda, Ramy Abou /
    Birowo, Ponco / Gherabi, Nazim / Ceyhan, Erman / Dong, Jie / Malhotra, Vineet / Durairajanayagam, Damayanthi / Kolbasi, Bircan / Bahar, Fahmi / Calik, Gokhan / Çayan, Selahittin / Pinggera, Germar-Michael / Calogero, Aldo E / Rajmil, Osvaldo / Mostafa, Taymour / Atmoko, Widi / Harraz, Ahmed M / Le, Tan V / de la Rosette, Jean / Hakim, Lukman / Pescatori, Edoardo / Sergeyev, Oleg / Rashed, Ayman / Saini, Pallavi / Agarwal, Ashok

    The world journal of men's health

    2024  Volume 42, Issue 2, Page(s) 321–337

    Abstract: Purpose: Varicoceles can be a source of elevated seminal oxidative stress (OS) and sperm DNA fragmentation (SDF). However, it remains unclear whether varicocele repair (VR) could reduce these parameters. This systematic review and meta-analysis (SRMA) ... ...

    Abstract Purpose: Varicoceles can be a source of elevated seminal oxidative stress (OS) and sperm DNA fragmentation (SDF). However, it remains unclear whether varicocele repair (VR) could reduce these parameters. This systematic review and meta-analysis (SRMA) aims to investigate the impact of VR on SDF and seminal malondialdehyde (MDA).
    Materials and methods: A literature search was performed in Scopus, PubMed, Ovid, Embase, and Cochrane databases. This SRMA included randomized controlled trials and observational studies reporting the pre- and postoperative levels of SDF and seminal OS in infertile men with clinical varicocele that underwent VR. Subgroup analyses included techniques of VR and SDF testing. The effect size was expressed as standardized mean difference (SMD).
    Results: Out of 1,632 abstracts assessed for eligibility, 29 studies with 1,491 infertile men were included. The analysis showed a significant reduction in SDF after VR, compared to preoperative values (SMD -1.125, 95% confidence interval [CI] -1.410, -0.840; p<0.0001) with high inter-study heterogeneity (I²=90.965%). Reduction in SDF was evident with microsurgical technique and non-microsurgical inguinal approaches (SMD -1.014, 95% CI -1.263, -0.765; p<0.0001, and SMD -1.495, 95% CI -2.116, -0.873; p<0.0001), respectively. Reduction in SDF was significant irrespective of testing was done by sperm chromatin dispersion (SMD -2.197, 95% CI -3.187, -1.207; p<0.0001), sperm chromatin structure assay (SMD -0.857, 95% CI -1.156, -0.559; p<0.0001) or TUNEL (SMD -1.599, 95% CI -2.478, -0.719; p<0.0001). A significant decrease in seminal MDA levels was observed following VR (SMD -2.450, 95% CI -3.903 to -0.997, p=0.001) with high inter-study heterogeneity (I²=93.7%).
    Conclusions: Using pre- and post-intervention data, this SRMA indicates a significant reduction in SDF and seminal MDA levels in infertile men with clinical varicocele treated with VR. These findings may have important implications for the future management of this selected group of infertile patients.
    Language English
    Publishing date 2024-01-02
    Publishing country Korea (South)
    Document type Journal Article
    ZDB-ID 2719786-4
    ISSN 2287-4690 ; 2287-4208
    ISSN (online) 2287-4690
    ISSN 2287-4208
    DOI 10.5534/wjmh.230235
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: Controversy and Consensus on Indications for Sperm DNA Fragmentation Testing in Male Infertility: A Global Survey, Current Guidelines, and Expert Recommendations.

    Agarwal, Ashok / Farkouh, Ala'a / Saleh, Ramadan / Abdel-Meguid Hamoda, Taha Abo-Almagd / Harraz, Ahmed M / Kavoussi, Parviz / Arafa, Mohamed / Salvio, Gianmaria / Rambhatla, Amarnath / Toprak, Tuncay / Gül, Murat / Phuoc, Nguyen Ho Vinh / Boitrelle, Florence / Birowo, Ponco / Ghayda, Ramy Abou / Cannarella, Rossella / Kuroda, Shinnosuke / Durairajanayagam, Damayanthi / Zini, Armand /
    Wyns, Christine / Sarikaya, Selcuk / Tremellen, Kelton / Mostafa, Taymour / Sokolakis, Ioannis / Evenson, Donald P / Henkel, Ralf / Zohdy, Wael / Chung, Eric / Ziouziou, Imad / Falcone, Marco / Russo, Giorgio I / Al-Hashimi, Manaf / Calogero, Aldo E / Ko, Edmund / Colpi, Giovanni / Lewis, Sheena / Serefoglu, Ege Can / Bahar, Fahmi / Martinez, Marlon / Nguyen, Quang / Ambar, Rafael F / Bakircioglu, Mustafa Emre / Kandil, Hussein / Mogharabian, Nasser / Sabbaghian, Marjan / Taniguchi, Hisanori / Tsujimura, Akira / Sajadi, Hesamoddin / Ibrahim, Wael / Atmoko, Widi / Vogiatzi, Paraskevi / Gunes, Sezgin / Sadighi Gilani, Mohammad Ali / Roychoudhury, Shubhadeep / Güngör, Nur Dokuzeylül / Hakim, Lukman / Adriansjah, Ricky / Kothari, Priyank / Jindal, Sunil / Amar, Edouard / Park, Hyun Jun / Long, Tran Quang Tien / Homa, Sheryl / Karthikeyan, Vilvapathy Senguttuvan / Zilaitiene, Birute / Maldonado Rosas, Israel / Marino, Angelo / Pescatori, Edoardo / Ozer, Cevahir / Akhavizadegan, Hamed / Garrido, Nicolas / Busetto, Gian Maria / Adamyan, Aram / Al-Marhoon, Mohamed / Elbardisi, Haitham / Dolati, Parisa / Darbandi, Mahsa / Darbandi, Sara / Balercia, Giancarlo / Pinggera, Germar-Michael / Micic, Sava / Ho, Christopher Chee Kong / Moussa, Mohamad / Preto, Mirko / Zenoaga-Barbăroșie, Cătălina / Smith, Ryan P / Kosgi, Raghavender / de la Rosette, Jean / El-Sakka, Ahmed I / Abumelha, Saad Mohammed / Mierzwa, Tiago Cesar / Ong, Teng Aik / Banihani, Saleem A / Bowa, Kasonde / Fukuhara, Shinichiro / Boeri, Luca / Danacıoğlu, Yavuz Onur / Gokalp, Fatih / Selim, Osama Mohamed / Cho, Chak-Lam / Tadros, Nicholas N / Ugur, Muhammet Rasit / Ozkent, Mehmet Serkan / Chiu, Peter / Kalkanli, Arif / Khalafalla, Kareim / Vishwakarma, Ranjit B / Finocchi, Federica / Andreadakis, Sotiris / Giulioni, Carlo / Çeker, Gökhan / Ceyhan, Erman / Malhotra, Vineet / Yilmaz, Mehmet / Timpano, Massimiliano / Barrett, Trenton L / Kim, Shannon Hee Kyung / Ahn, Sun-Tae / Giacone, Filippo / Palani, Ayad / Duarsa, Gede Wirya Kusuma / Kadioglu, Ates / Gadda, Franco / Zylbersztejn, Daniel Suslik / Aydos, Kaan / Kulaksız, Deniz / Gupte, Deepak / Calik, Gokhan / Karna, Keshab Kumar / Drakopoulos, Panagiotis / Baser, Aykut / Kumar, Vijay / Molina, Juan Manuel Corral / Rajmil, Osvaldo / Ferreira, Raphael H / Leonardi, Sofia / Avoyan, Armen / Sogutdelen, Emrullah / Franco, Giorgio / Ramsay, Jonathan / Ramirez, Liliana / Shah, Rupin

    The world journal of men's health

    2023  Volume 41, Issue 3, Page(s) 575–602

    Abstract: Purpose: Sperm DNA fragmentation (SDF) testing was recently added to the sixth edition of the World Health Organization laboratory manual for the examination and processing of human semen. Many conditions and risk factors have been associated with ... ...

    Abstract Purpose: Sperm DNA fragmentation (SDF) testing was recently added to the sixth edition of the World Health Organization laboratory manual for the examination and processing of human semen. Many conditions and risk factors have been associated with elevated SDF; therefore, it is important to identify the population of infertile men who might benefit from this test. The purpose of this study was to investigate global practices related to indications for SDF testing, compare the relevant professional society guideline recommendations, and provide expert recommendations.
    Materials and methods: Clinicians managing male infertility were invited to take part in a global online survey on SDF clinical practices. This was conducted following the CHERRIES checklist criteria. The responses were compared to professional society guideline recommendations related to SDF and the appropriate available evidence. Expert recommendations on indications for SDF testing were then formulated, and the Delphi method was used to reach consensus.
    Results: The survey was completed by 436 experts from 55 countries. Almost 75% of respondents test for SDF in all or some men with unexplained or idiopathic infertility, 39% order it routinely in the work-up of recurrent pregnancy loss (RPL), and 62.2% investigate SDF in smokers. While 47% of reproductive urologists test SDF to support the decision for varicocele repair surgery when conventional semen parameters are normal, significantly fewer general urologists (23%; p=0.008) do the same. Nearly 70% would assess SDF before assisted reproductive technologies (ART), either always or for certain conditions. Recurrent ART failure is a common indication for SDF testing. Very few society recommendations were found regarding SDF testing.
    Conclusions: This article presents the largest global survey on the indications for SDF testing in infertile men, and demonstrates diverse practices. Furthermore, it highlights the paucity of professional society guideline recommendations. Expert recommendations are proposed to help guide clinicians.
    Language English
    Publishing date 2023-04-10
    Publishing country Korea (South)
    Document type Journal Article
    ZDB-ID 2719786-4
    ISSN 2287-4690 ; 2287-4208
    ISSN (online) 2287-4690
    ISSN 2287-4208
    DOI 10.5534/wjmh.220282
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article: Technical Aspects and Clinical Limitations of Sperm DNA Fragmentation Testing in Male Infertility: A Global Survey, Current Guidelines, and Expert Recommendations.

    Agarwal, Ashok / Farkouh, Ala'a / Saleh, Ramadan / Hamoda, Taha Abo-Almagd Abdel-Meguid / Salvio, Gianmaria / Boitrelle, Florence / Harraz, Ahmed M / Ghayda, Ramy Abou / Kavoussi, Parviz / Gül, Murat / Toprak, Tuncay / Russo, Giorgio Ivan / Durairajanayagam, Damayanthi / Rambhatla, Amarnath / Birowo, Ponco / Cannarella, Rossella / Phuoc, Nguyen Ho Vinh / Zini, Armand / Arafa, Mohamed /
    Wyns, Christine / Tremellen, Kelton / Sarıkaya, Selçuk / Lewis, Sheena / Evenson, Donald P / Ko, Edmund / Calogero, Aldo E / Bahar, Fahmi / Martínez, Marlon / Ambar, Rafael F / Colpi, Giovanni M / Bakircioglu, Mustafa Emre / Henkel, Ralf / Kandil, Hussein / Serefoglu, Ege Can / Alfakhri, Abdullah / Tsujimura, Akira / Kheradmand, Alireza / Marino, Angelo / Adamyan, Aram / Zilaitiene, Birute / Ozer, Cevahir / Pescatori, Edoardo / Vogiatzi, Paraskevi / Busetto, Gian Maria / Balercia, Giancarlo / Elbardisi, Haitham / Akhavizadegan, Hamed / Sajadi, Hesamoddin / Taniguchi, Hisanori / Park, Hyun Jun / Maldonado Rosas, Israel / Al-Marhoon, Mohamed / Sadighi Gilani, Mohammad Ali / Alhathal, Naif / Quang, Nguyen / Pinggera, Germar-Michael / Kothari, Priyank / Micic, Sava / Homa, Sheryl / Long, Tran Quang Tien / Zohdy, Wael / Atmoko, Widi / Ibrahim, Wael / Sabbaghian, Marjan / Abumelha, Saad Mohammed / Chung, Eric / Ugur, Muhammet Rasit / Ozkent, Mehmet Serkan / Selim, Osama / Darbandi, Mahsa / Fukuhara, Shinichiro / Jamali, Mounir / de la Rosette, Jean / Kuroda, Shinnosuke / Smith, Ryan P / Baser, Aykut / Kalkanli, Arif / Tadros, Nicholas N / Aydos, Kaan / Mierzwa, Tiago Cesar / Khalafalla, Kareim / Malhotra, Vineet / Moussa, Mohamad / Finocchi, Federica / Rachman, Rinaldo Indra / Giulioni, Carlo / Avidor-Reiss, Tomer / Kahraman, Oguzhan / Çeker, Gökhan / Zenoaga-Barbăroșie, Cătălina / Barrett, Trenton L / Yilmaz, Mehmet / Kadioglu, Ates / Jindal, Sunil / Omran, Huda / Bocu, Kadir / Karthikeyan, Vilvapathy Senguttuvan / Franco, Giorgio / Solorzano, Jesús Fernando / Vishwakarma, Ranjit B / Arianto, Eko / Garrido, Nicolas / Jain, Divyanu / Gherabi, Nazim / Sokolakis, Ioannis / Palani, Ayad / Calik, Gokhan / Kulaksiz, Deniz / Simanaviciene, Vaida / Simopoulou, Mara / Güngör, Nur Dokuzeylül / Blecher, Gideon / Falcone, Marco / Jezek, Davor / Preto, Mirko / Amar, Edouard / Le, Tan V / Ahn, Sun Tae / Rezano, Andri / Singh, Keerti / Rocco, Lucia / Savira, Missy / Rajmil, Osvaldo / Darbandi, Sara / Sogutdelen, Emrullah / Boeri, Luca / Hernández, Guadalupe / Hakim, Lukman / Morimoto, Yoshiharu / Japari, Andrian / Sofikitis, Nikolaos / Altay, Baris / Metin Mahmutoglu, Asli / Al Hashimi, Manaf / Ziouziou, Imad / Anagnostopoulou, Christina / Lin, Haocheng / Shah, Rupin

    The world journal of men's health

    2023  Volume 42, Issue 1, Page(s) 202–215

    Abstract: Purpose: Sperm DNA fragmentation (SDF) is a functional sperm abnormality that can impact reproductive potential, for which four assays have been described in the recently published sixth edition of the WHO laboratory manual for the examination and ... ...

    Abstract Purpose: Sperm DNA fragmentation (SDF) is a functional sperm abnormality that can impact reproductive potential, for which four assays have been described in the recently published sixth edition of the WHO laboratory manual for the examination and processing of human semen. The purpose of this study was to examine the global practices related to the use of SDF assays and investigate the barriers and limitations that clinicians face in incorporating these tests into their practice.
    Materials and methods: Clinicians managing male infertility were invited to complete an online survey on practices related to SDF diagnostic and treatment approaches. Their responses related to the technical aspects of SDF testing, current professional society guidelines, and the literature were used to generate expert recommendations via the Delphi method. Finally, challenges related to SDF that the clinicians encounter in their daily practice were captured.
    Results: The survey was completed by 436 reproductive clinicians. Overall, terminal deoxynucleotidyl transferase deoxyuridine triphosphate Nick-End Labeling (TUNEL) is the most commonly used assay chosen by 28.6%, followed by the sperm chromatin structure assay (24.1%), and the sperm chromatin dispersion (19.1%). The choice of the assay was largely influenced by availability (70% of respondents). A threshold of 30% was the most selected cut-off value for elevated SDF by 33.7% of clinicians. Of respondents, 53.6% recommend SDF testing after 3 to 5 days of abstinence. Although 75.3% believe SDF testing can provide an explanation for many unknown causes of infertility, the main limiting factors selected by respondents are a lack of professional society guideline recommendations (62.7%) and an absence of globally accepted references for SDF interpretation (50.3%).
    Conclusions: This study represents the largest global survey on the technical aspects of SDF testing as well as the barriers encountered by clinicians. Unified global recommendations regarding clinician implementation and standard laboratory interpretation of SDF testing are crucial.
    Language English
    Publishing date 2023-08-24
    Publishing country Korea (South)
    Document type Journal Article
    ZDB-ID 2719786-4
    ISSN 2287-4690 ; 2287-4208
    ISSN (online) 2287-4690
    ISSN 2287-4208
    DOI 10.5534/wjmh.230076
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article: Global Practice Patterns and Variations in the Medical and Surgical Management of Non-Obstructive Azoospermia: Results of a World-Wide Survey, Guidelines and Expert Recommendations.

    Rambhatla, Amarnath / Shah, Rupin / Ziouziou, Imad / Kothari, Priyank / Salvio, Gianmaria / Gul, Murat / Hamoda, Taha / Kavoussi, Parviz / Atmoko, Widi / Toprak, Tuncay / Birowo, Ponco / Ko, Edmund / Arafa, Mohamed / Ghayda, Ramy Abou / Karthikeyan, Vilvapathy Senguttuvan / Russo, Giorgio Ivan / Pinggera, Germar-Michael / Chung, Eric / Harraz, Ahmed M /
    Martinez, Marlon / Phuoc, Nguyen Ho Vinh / Tadros, Nicholas / Saleh, Ramadan / Savira, Missy / Colpi, Giovanni M / Zohdy, Wael / Pescatori, Edoardo / Park, Hyun Jun / Fukuhara, Shinichiro / Tsujimura, Akira / Rojas-Cruz, Cesar / Marino, Angelo / Mak, Siu King / Amar, Edouard / Ibrahim, Wael / Sindhwani, Puneet / Alhathal, Naif / Busetto, Gian Maria / Al Hashimi, Manaf / El-Sakka, Ahmed / Ramazan, Asci / Dimitriadis, Fotios / Timpano, Massimiliano / Jezek, Davor / Altay, Baris / Zylbersztejn, Daniel Suslik / Wong, Michael Yc / Moon, Du Geon / Wyns, Christine / Gamidov, Safar / Akhavizadegan, Hamed / Franceschelli, Alessandro / Aydos, Kaan / Quang, Nguyen / Ashour, Shedeed / Al Dayel, Adel / Al-Marhoon, Mohammed S / Micic, Sava / Binsaleh, Saleh / Hussein, Alayman / Elbardisi, Haitham / Mostafa, Taymour / Ramsay, Jonathan / Zachariou, Athanasios / Abdelrahman, Islam Fathy Soliman / Rajmil, Osvaldo / Kalkanli, Arif / Molina, Juan Manuel Corral / Bocu, Kadir / Duarsa, Gede Wirya Kusuma / Çeker, Gökhan / Serefoglu, Ege Can / Bahar, Fahmi / Gherabi, Nazim / Kuroda, Shinnosuke / Bouzouita, Abderrazak / Gudeloglu, Ahmet / Ceyhan, Erman / Hasan, Mohamed Saeed Mohamed / Musa, Muhammad Ujudud / Motawi, Ahmad / Cho, Chak-Lam / Taniguchi, Hisanori / Ho, Christopher Chee Kong / Vazquez, Jesus Fernando Solorzano / Mutambirwa, Shingai / Gungor, Nur Dokuzeylul / Bendayan, Marion / Giulioni, Carlo / Baser, Aykut / Falcone, Marco / Boeri, Luca / Blecher, Gideon / Kheradmand, Alireza / Sethupathy, Tamilselvi / Adriansjah, Ricky / Narimani, Nima / Konstantinidis, Charalampos / Nguyen, Tuan Thanh / Japari, Andrian / Dolati, Parisa / Singh, Keerti / Ozer, Cevahir / Sarikaya, Selcuk / Sheibak, Nadia / Bosco, Ndagijimana Jean / Özkent, Mehmet Serkan / Le, Sang Thanh / Sokolakis, Ioannis / Katz, Darren / Smith, Ryan / Truong, Manh Nguyen / Le, Tan V / Huang, Zhongwei / Deger, Muslim Dogan / Arslan, Umut / Calik, Gokhan / Franco, Giorgio / Rashed, Ayman / Kahraman, Oguzhan / Andreadakis, Sotiris / Putra, Rosadi / Balercia, Giancarlo / Khalafalla, Kareim / Cannarella, Rossella / Tuân, Anh Ðăng / El Meliegy, Amr / Zilaitiene, Birute / Ramirez, Marlene Lizbeth Zamora / Giacone, Filippo / Calogero, Aldo E / Makarounis, Konstantinos / Jindal, Sunil / Hoai, Bac Nguyen / Banthia, Ravi / Peña, Marcelo Rodriguez / Moorthy, Dharani / Adamyan, Aram / Kulaksiz, Deniz / Kandil, Hussein / Sofikitis, Nikolaos / Salzano, Ciro / Jungwirth, Andreas / Banka, Surendra Reddy / Mierzwa, Tiago Cesar / Turunç, Tahsin / Jain, Divyanu / Avoyan, Armen / Salacone, Pietro / Kadıoğlu, Ateş / Gupta, Chirag / Lin, Haocheng / Shamohammadi, Iman / Mogharabian, Nasser / Barrett, Trenton / Danacıoğlu, Yavuz Onur / Crafa, Andrea / Daoud, Salima / Malhotra, Vineet / Almardawi, Abdulmalik / Selim, Osama Mohamed / Moussa, Mohamad / Haghdani, Saeid / Duran, Mesut Berkan / Kunz, Yannic / Preto, Mirko / Eugeni, Elena / Nguyen, Thang / Elshahid, Ahmed Rashad / Suyono, Seso Sulijaya / Parikesit, Dyandra / Nada, Essam / Orozco, Eduardo Gutiérrez / Boitrelle, Florence / Trang, Nguyen Thi Minh / Jamali, Mounir / Nair, Raju / Ruzaev, Mikhail / Gadda, Franco / Thomas, Charalampos / Ferreira, Raphael Henrique / Gul, Umit / Maruccia, Serena / Kanbur, Ajay / Kinzikeeva, Ella / Abumelha, Saad Mohammed / Kosgi, Raghavender / Gokalp, Fatih / Soebadi, Mohammad Ayodhia / Paul, Gustavo Marquesine / Sajadi, Hesamoddin / Gupte, Deepak / Ambar, Rafael F / Sogutdelen, Emrullah / Singla, Karun / Basukarno, Ari / Kim, Shannon Hee Kyung / Gilani, Mohammad Ali Sadighi / Nagao, Koichi / Brodjonegoro, Sakti Ronggowardhana / Rezano, Andri / Elkhouly, Mohamed / Mazzilli, Rossella / Farsi, Hasan M A / Ba, Hung Nguyen / Alali, Hamed / Kafetzis, Dimitrios / Long, Tran Quang Tien / Alsaid, Sami / Cuong, Hoang Bao Ngoc / Oleksandr, Knigavko / Mustafa, Akhmad / Acosta, Herik / Pai, Hrishikesh / Şahin, Bahadır / Arianto, Eko / Teo, Colin / Jayaprakash, Sanjay Prakash / Rachman, Rinaldo Indra / Yenice, Mustafa Gurkan / Sefrioui, Omar / Priyadarshi, Shivam / Tanic, Marko / Alfatlaw, Noor Kareem / Rizaldi, Fikri / Vishwakarma, Ranjit B / Kanakis, George / Cherian, Dinesh Thomas / Lee, Joe / Galstyan, Raisa / Keskin, Hakan / Wurzacher, Janan / Seno, Doddy Hami / Noegroho, Bambang S / Margiana, Ria / Javed, Qaisar / Castiglioni, Fabrizio / Tanwar, Raman / Puigvert, Ana / Kaya, Coşkun / Purnomo, Medianto / Yazbeck, Chadi / Amir, Azwar / Borges, Edson / Bellavia, Marina / Deswanto, Isaac Ardianson / Kv, Vinod / Liguori, Giovanni / Minh, Dang Hoang / Siddiqi, Kashif / Colombo, Fulvio / Zini, Armand / Patel, Niket / Çayan, Selahittin / Al-Kawaz, Ula / Ragab, Maged / Hebrard, Guadalupe Hernández / de la Rosette, Jean / Efesoy, Ozan / Hoffmann, Ivan / Teixeira, Thiago Afonso / Saylam, Barış / Delgadillo, Daniela / Agarwal, Ashok

    The world journal of men's health

    2024  

    Abstract: Purpose: Non-obstructive azoospermia (NOA) is a common, but complex problem, with multiple therapeutic options and a lack of clear guidelines. Hence, there is considerable controversy and marked variation in the management of NOA. This survey evaluates ... ...

    Abstract Purpose: Non-obstructive azoospermia (NOA) is a common, but complex problem, with multiple therapeutic options and a lack of clear guidelines. Hence, there is considerable controversy and marked variation in the management of NOA. This survey evaluates contemporary global practices related to medical and surgical management for patients with NOA.
    Materials and methods: A 56-question online survey covering various aspects of the evaluation and management of NOA was sent to specialists around the globe. This paper analyzes the results of the second half of the survey dealing with the management of NOA. Results have been compared to current guidelines, and expert recommendations have been provided using a Delphi process.
    Results: Participants from 49 countries submitted 336 valid responses. Hormonal therapy for 3 to 6 months was suggested before surgical sperm retrieval (SSR) by 29.6% and 23.6% of participants for normogonadotropic hypogonadism and hypergonadotropic hypogonadism respectively. The SSR rate was reported as 50.0% by 26.0% to 50.0% of participants. Interestingly, 46.0% reported successful SSR in <10% of men with Klinefelter syndrome and 41.3% routinely recommended preimplantation genetic testing. Varicocele repair prior to SSR is recommended by 57.7%. Half of the respondents (57.4%) reported using ultrasound to identify the most vascularized areas in the testis for SSR. One-third proceed directly to microdissection testicular sperm extraction (mTESE) in every case of NOA while others use a staged approach. After a failed conventional TESE, 23.8% wait for 3 months, while 33.1% wait for 6 months before proceeding to mTESE. The cut-off of follicle-stimulating hormone for positive SSR was reported to be 12-19 IU/mL by 22.5% of participants and 20-40 IU/mL by 27.8%, while 31.8% reported no upper limit.
    Conclusions: This is the largest survey to date on the real-world medical and surgical management of NOA by reproductive experts. It demonstrates a diverse practice pattern and highlights the need for evidence-based international consensus guidelines.
    Language English
    Publishing date 2024-04-04
    Publishing country Korea (South)
    Document type Journal Article
    ZDB-ID 2719786-4
    ISSN 2287-4690 ; 2287-4208
    ISSN (online) 2287-4690
    ISSN 2287-4208
    DOI 10.5534/wjmh.230339
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article: Global Practice Patterns in the Evaluation of Non-Obstructive Azoospermia: Results of a World-Wide Survey and Expert Recommendations.

    Shah, Rupin / Rambhatla, Amarnath / Atmoko, Widi / Martinez, Marlon / Ziouziou, Imad / Kothari, Priyank / Tadros, Nicholas / Phuoc, Nguyen Ho Vinh / Kavoussi, Parviz / Harraz, Ahmed / Salvio, Gianmaria / Gul, Murat / Hamoda, Taha / Toprak, Tuncay / Birowo, Ponco / Ko, Edmund / Arafa, Mohamed / Ghayda, Ramy Abou / Karthikeyan, Vilvapathy Senguttuvan /
    Saleh, Ramadan / Russo, Giorgio Ivan / Pinggera, Germar-Michael / Chung, Eric / Savira, Missy / Colpi, Giovanni M / Zohdy, Wael / Pescatori, Edoardo / Park, Hyun Jun / Fukuhara, Shinichiro / Tsujimura, Akira / Rojas-Cruz, Cesar / Marino, Angelo / Mak, Siu King / Amar, Edouard / Ibrahim, Wael / Sindhwani, Puneet / Alhathal, Naif / Busetto, Gian Maria / Al Hashimi, Manaf / El-Sakka, Ahmed / Ramazan, Asci / Dimitriadis, Fotios / Timpano, Massimiliano / Jezek, Davor / Altay, Baris / Zylbersztejn, Daniel Suslik / Wong, Michael Yc / Moon, Du Geon / Wyns, Christine / Gamidov, Safar / Akhavizadegan, Hamed / Franceschelli, Alessandro / Aydos, Kaan / Quang, Vinh Nguyen / Ashour, Shedeed / Al Dayel, Adel / Al-Marhoon, Mohamed S / Micic, Sava / Binsaleh, Saleh / Hussein, Alayman / Elbardisi, Haitham / Mostafa, Taymour / Taha, Emad / Ramsay, Jonathan / Zachariou, Athanasios / Abdelrahman, Islam Fathy Soliman / Rajmil, Osvaldo / Kalkanli, Arif / Molina, Juan Manuel Corral / Bocu, Kadir / Duarsa, Gede Wirya Kusuma / Ceker, Gokhan / Serefoglu, Ege Can / Bahar, Fahmi / Gherabi, Nazim / Kuroda, Shinnosuke / Bouzouita, Abderrazak / Gudeloglu, Ahmet / Ceyhan, Erman / Hasan, Mohamed Saeed Mohamed / Musa, Muhammad Ujudud / Motawi, Ahmad / Chak-Lam, Cho / Taniguchi, Hisanori / Ho, Christopher Chee Kong / Vazquez, Jesus Fernando Solorzano / Mutambirwa, Shingai / Gungor, Nur Dokuzeylul / Bendayan, Marion / Giulioni, Carlo / Baser, Aykut / Falcone, Marco / Boeri, Luca / Blecher, Gideon / Kheradmand, Alireza / Sethupathy, Tamilselvi / Adriansjah, Ricky / Narimani, Nima / Konstantinidis, Charalampos / Nguyen, Tuan Thanh / Japari, Andrian / Dolati, Parisa / Singh, Keerti / Ozer, Cevahir / Sarikaya, Selcuk / Sheibak, Nadia / Bosco, Ndagijimana Jean / Özkent, Mehmet Serkan / Le, Sang Thanh / Sokolakis, Ioannis / Katz, Darren / Smith, Ryan / Truong, Manh Nguyen / Le, Tan V / Huang, Zhongwei / Deger, Muslim Dogan / Arslan, Umut / Calik, Gokhan / Franco, Giorgio / Rashed, Ayman / Kahraman, Oguzhan / Andreadakis, Sotiris / Putra, Rosadi / Balercia, Giancarlo / Khalafalla, Kareim / Cannarella, Rossella / Tuân, Anh Ðăng / El Meliegy, Amr / Zilaitiene, Birute / Ramirez, Marlene Lizbeth Zamora / Giacone, Filippo / Calogero, Aldo E / Makarounis, Konstantinos / Jindal, Sunil / Hoai, Bac Nguyen / Banthia, Ravi / Peña, Marcelo Rodriguez / Moorthy, Dharani / Adamyan, Aram / Kulaksiz, Deniz / Kandil, Hussein / Sofikitis, Nikolaos / Salzano, Ciro / Jungwirth, Andreas / Banka, Surendra Reddy / Mierzwa, Tiago Cesar / Turunç, Tahsin / Jain, Divyanu / Avoyan, Armen / Salacone, Pietro / Kadıoğlu, Ateş / Gupta, Chirag / Lin, Haocheng / Shamohammadi, Iman / Mogharabian, Nasser / Barrett, Trenton / Danacıoğlu, Yavuz Onur / Crafa, Andrea / Daoud, Salima / Malhotra, Vineet / Almardawi, Abdulmalik / Selim, Osama Mohamed / Moussa, Mohamad / Haghdani, Saeid / Duran, Mesut Berkan / Kunz, Yannic / Preto, Mirko / Eugeni, Elena / Nguyen, Thang / Elshahid, Ahmed Rashad / Suyono, Seso Sulijaya / Parikesit, Dyandra / Nada, Essam / Orozco, Eduardo Gutiérrez / Boitrelle, Florence / Trang, Nguyen Thi Minh / Jamali, Mounir / Nair, Raju / Ruzaev, Mikhail / Gadda, Franco / Thomas, Charalampos / Ferreira, Raphael Henrique / Gul, Umit / Maruccia, Serena / Kanbur, Ajay / Kinzikeeva, Ella / Abumelha, Saad / Quang, Nguyen / Kosgi, Raghavender / Gokalp, Fatih / Soebadi, Mohammad Ayodhia / Paul, Gustavo Marquesine / Sajadi, Hesamoddin / Gupte, Deepak / Ambar, Rafael F / Sogutdelen, Emrullah / Singla, Karun / Basurkano, Ari / Kim, Shannon Hee Kyung / Gilani, Mohammad Ali Sadighi / Nagao, Koichi / Brodjonegoro, Sakti Ronggowardhana / Rezano, Andri / Elkhouly, Mohamed / Mazzilli, Rossella / Farsi, Hasan M A / Ba, Hung Nguyen / Alali, Hamed / Kafetzis, Dimitrios / Long, Tran Quang Tien / Alsaid, Sami / Cuong, Hoang Bao Ngoc / Oleksandr, Knigavko / Mustafa, Akhmad / Acosta, Herik / Pai, Hrishikesh / Şahin, Bahadır / Arianto, Eko / Teo, Colin / Jayaprakash, Sanjay Prakash / Rachman, Rinaldo Indra / Yenice, Mustafa Gurkan / Sefrioui, Omar / Paghdar, Smit / Priyadarshi, Shivam / Tanic, Marko / Alfatlawy, Noor Kareem / Rizaldi, Fikri / Vishwakarma, Ranjit B / Kanakis, George / Cherian, Dinesh Thomas / Lee, Joe / Galstyan, Raisa / Keskin, Hakan / Wurzacher, Jana / Seno, Doddy Hami / Noegroho, Bambang S / Margiana, Ria / Javed, Qaisar / Castiglioni, Fabrizio / Tanwar, Raman / Puigvert, Ana / Kaya, Coşkun / Purnomo, Medianto / Yazbeck, Chadi / Amir, Azwar / Borges, Edson / Bellavia, Marina / Deswanto, Isaac Ardianson / V, Vinod K / Liguori, Giovanni / Minh, Dang Hoang / Siddiqi, Kashif / Colombo, Fulvio / Zini, Armand / Patel, Niket / Çayan, Selahittin / Al-Kawaz, Ula / Ragab, Maged / Hebrard, Guadalupe Hernández / Hoffmann, Ivan / Efesoy, Ozan / Saylam, Barış / Agarwal, Ashok

    The world journal of men's health

    2024  

    Abstract: Purpose: Non-obstructive azoospermia (NOA) represents the persistent absence of sperm in ejaculate without obstruction, stemming from diverse disease processes. This survey explores global practices in NOA diagnosis, comparing them with guidelines and ... ...

    Abstract Purpose: Non-obstructive azoospermia (NOA) represents the persistent absence of sperm in ejaculate without obstruction, stemming from diverse disease processes. This survey explores global practices in NOA diagnosis, comparing them with guidelines and offering expert recommendations.
    Materials and methods: A 56-item questionnaire survey on NOA diagnosis and management was conducted globally from July to September 2022. This paper focuses on part 1, evaluating NOA diagnosis. Data from 367 participants across 49 countries were analyzed descriptively, with a Delphi process used for expert recommendations.
    Results: Of 336 eligible responses, most participants were experienced attending physicians (70.93%). To diagnose azoospermia definitively, 81.7% requested two semen samples. Commonly ordered hormone tests included serum follicle-stimulating hormone (FSH) (97.0%), total testosterone (92.9%), and luteinizing hormone (86.9%). Genetic testing was requested by 66.6%, with karyotype analysis (86.2%) and Y chromosome microdeletions (88.3%) prevalent. Diagnostic testicular biopsy, distinguishing obstructive azoospermia (OA) from NOA, was not performed by 45.1%, while 34.6% did it selectively. Differentiation relied on physical examination (76.1%), serum hormone profiles (69.6%), and semen tests (68.1%). Expectations of finding sperm surgically were higher in men with normal FSH, larger testes, and a history of sperm in ejaculate.
    Conclusions: This expert survey, encompassing 367 participants from 49 countries, unveils congruence with recommended guidelines in NOA diagnosis. However, noteworthy disparities in practices suggest a need for evidence-based, international consensus guidelines to standardize NOA evaluation, addressing existing gaps in professional recommendations.
    Language English
    Publishing date 2024-04-03
    Publishing country Korea (South)
    Document type Journal Article
    ZDB-ID 2719786-4
    ISSN 2287-4690 ; 2287-4208
    ISSN (online) 2287-4690
    ISSN 2287-4208
    DOI 10.5534/wjmh.230333
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article: Controversy and Consensus on the Management of Elevated Sperm DNA Fragmentation in Male Infertility: A Global Survey, Current Guidelines, and Expert Recommendations.

    Farkouh, Ala'a / Agarwal, Ashok / Hamoda, Taha Abo-Almagd Abdel-Meguid / Kavoussi, Parviz / Saleh, Ramadan / Zini, Armand / Arafa, Mohamed / Harraz, Ahmed M / Gul, Murat / Karthikeyan, Vilvapathy Senguttuvan / Durairajanayagam, Damayanthi / Rambhatla, Amarnath / Boitrelle, Florence / Chung, Eric / Birowo, Ponco / Toprak, Tuncay / Ghayda, Ramy Abou / Cannarella, Rossella / Phuoc, Nguyen Ho Vinh /
    Dimitriadis, Fotios / Russo, Giorgio I / Sokolakis, Ioannis / Mostafa, Taymour / Makarounis, Konstantinos / Ziouziou, Imad / Kuroda, Shinnosuke / Bendayan, Marion / Kaiyal, Raneen Sawaid / Japari, Andrian / Simopoulou, Mara / Rocco, Lucia / Garrido, Nicolas / Gherabi, Nazim / Bocu, Kadir / Kahraman, Oguzhan / Le, Tan V / Wyns, Christine / Tremellen, Kelton / Sarikaya, Selcuk / Lewis, Sheena / Evenson, Donald P / Ko, Edmund / Calogero, Aldo E / Bahar, Fahmi / Martinez, Marlon / Crafa, Andrea / Nguyen, Quang / Ambar, Rafael F / Colpi, Giovanni / Bakircioglu, Mustafa Emre / Henkel, Ralf / Kandil, Hussein / Serefoglu, Ege Can / Alarbid, Abdullah / Tsujimura, Akira / Kheradmand, Alireza / Anagnostopoulou, Christina / Marino, Angelo / Adamyan, Aram / Zilaitiene, Birute / Ozer, Cevahir / Pescatori, Edoardo / Vogiatzi, Paraskevi / Busetto, Gian Maria / Balercia, Giancarlo / Elbardisi, Haitham / Akhavizadegan, Hamed / Sajadi, Hesamoddin / Taniguchi, Hisanori / Park, Hyun Jun / Maldonado Rosas, Israel / Al-Marhoon, Mohamed / Sadighi Gilani, Mohammad Ali / Alhathal, Naif / Pinggera, Germar-Michael / Kothari, Priyank / Mogharabian, Nasser / Micic, Sava / Homa, Sheryl / Darbandi, Sara / Long, Tran Quang Tien / Zohdy, Wael / Atmoko, Widi / Sabbaghian, Marjan / Ibrahim, Wael / Smith, Ryan P / Ho, Christopher Chee Kong / de la Rosette, Jean / El-Sakka, Ahmed I / Preto, Mirko / Zenoaga-Barbăroșie, Cătălina / Abumelha, Saad Mohammed / Baser, Aykut / Aydos, Kaan / Ramirez-Dominguez, Liliana / Kumar, Vijay / Ong, Teng Aik / Mierzwa, Tiago Cesar / Adriansjah, Ricky / Banihani, Saleem A / Bowa, Kasonde / Fukuhara, Shinichiro / Rodriguez Peña, Marcelo / Moussa, Mohamad / Ari, Umut Çağın / Cho, Chak-Lam / Tadros, Nicholas N / Ugur, Muhammet Rasit / Amar, Edouard / Falcone, Marco / Santer, Frederic Romain / Kalkanli, Arif / Karna, Keshab Kumar / Khalafalla, Kareim / Vishwakarma, Ranjit B / Finocchi, Federica / Giulioni, Carlo / Ceyhan, Erman / Çeker, Gökhan / Yazbeck, Chadi / Rajmil, Osvaldo / Yilmaz, Mehmet / Altay, Baris / Barrett, Trenton L / Ngoo, Kay Seong / Roychoudhury, Shubhadeep / Salvio, Gianmaria / Lin, Haocheng / Kadioglu, Ates / Timpano, Massimiliano / Avidor-Reiss, Tomer / Hakim, Lukman / Sindhwani, Puneet / Franco, Giorgio / Singh, Rajender / Giacone, Filippo / Ruzaev, Mikhail / Kosgi, Raghavender / Sofikitis, Nikolaos / Palani, Ayad / Calik, Gokhan / Kulaksız, Deniz / Jezek, Davor / Al Hashmi, Manaf / Drakopoulos, Panagiotis / Omran, Huda / Leonardi, Sofia / Celik-Ozenci, Ciler / Güngör, Nur Dokuzeylül / Ramsay, Jonathan / Amano, Toshiyasu / Sogutdelen, Emrullah / Duarsa, Gede Wirya Kusuma / Chiba, Koji / Jindal, Sunil / Savira, Missy / Boeri, Luca / Borges, Edson / Gupte, Deepak / Gokalp, Fatih / Hebrard, Guadalupe Hernández / Minhas, Suks / Shah, Rupin

    The world journal of men's health

    2023  Volume 41, Issue 4, Page(s) 809–847

    Abstract: Purpose: Sperm DNA fragmentation (SDF) has been associated with male infertility and poor outcomes of assisted reproductive technology (ART). The purpose of this study was to investigate global practices related to the management of elevated SDF in ... ...

    Abstract Purpose: Sperm DNA fragmentation (SDF) has been associated with male infertility and poor outcomes of assisted reproductive technology (ART). The purpose of this study was to investigate global practices related to the management of elevated SDF in infertile men, summarize the relevant professional society recommendations, and provide expert recommendations for managing this condition.
    Materials and methods: An online global survey on clinical practices related to SDF was disseminated to reproductive clinicians, according to the CHERRIES checklist criteria. Management protocols for various conditions associated with SDF were captured and compared to the relevant recommendations in professional society guidelines and the appropriate available evidence. Expert recommendations and consensus on the management of infertile men with elevated SDF were then formulated and adapted using the Delphi method.
    Results: A total of 436 experts from 55 different countries submitted responses. As an initial approach, 79.1% of reproductive experts recommend lifestyle modifications for infertile men with elevated SDF, and 76.9% prescribe empiric antioxidants. Regarding antioxidant duration, 39.3% recommend 4-6 months and 38.1% recommend 3 months. For men with unexplained or idiopathic infertility, and couples experiencing recurrent miscarriages associated with elevated SDF, most respondents refer to ART 6 months after failure of conservative and empiric medical management. Infertile men with clinical varicocele, normal conventional semen parameters, and elevated SDF are offered varicocele repair immediately after diagnosis by 31.4%, and after failure of antioxidants and conservative measures by 40.9%. Sperm selection techniques and testicular sperm extraction are also management options for couples undergoing ART. For most questions, heterogenous practices were demonstrated.
    Conclusions: This paper presents the results of a large global survey on the management of infertile men with elevated SDF and reveals a lack of consensus among clinicians. Furthermore, it demonstrates the scarcity of professional society guidelines in this regard and attempts to highlight the relevant evidence. Expert recommendations are proposed to help guide clinicians.
    Language English
    Publishing date 2023-04-20
    Publishing country Korea (South)
    Document type Journal Article
    ZDB-ID 2719786-4
    ISSN 2287-4690 ; 2287-4208
    ISSN (online) 2287-4690
    ISSN 2287-4208
    DOI 10.5534/wjmh.230008
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article: Consensus and Diversity in the Management of Varicocele for Male Infertility: Results of a Global Practice Survey and Comparison with Guidelines and Recommendations.

    Shah, Rupin / Agarwal, Ashok / Kavoussi, Parviz / Rambhatla, Amarnath / Saleh, Ramadan / Cannarella, Rossella / Harraz, Ahmed M / Boitrelle, Florence / Kuroda, Shinnosuke / Hamoda, Taha Abo-Almagd Abdel-Meguid / Zini, Armand / Ko, Edmund / Calik, Gokhan / Toprak, Tuncay / Kandil, Hussein / Gül, Murat / Bakırcıoğlu, Mustafa Emre / Parekh, Neel / Russo, Giorgio Ivan /
    Tadros, Nicholas / Kadioglu, Ates / Arafa, Mohamed / Chung, Eric / Rajmil, Osvaldo / Dimitriadis, Fotios / Malhotra, Vineet / Salvio, Gianmaria / Henkel, Ralf / Le, Tan V / Sogutdelen, Emrullah / Vij, Sarah / Alarbid, Abdullah / Gudeloglu, Ahmet / Tsujimura, Akira / Calogero, Aldo E / El Meliegy, Amr / Crafa, Andrea / Kalkanli, Arif / Baser, Aykut / Hazir, Berk / Giulioni, Carlo / Cho, Chak-Lam / Ho, Christopher C K / Salzano, Ciro / Zylbersztejn, Daniel Suslik / Tien, Dung Mai Ba / Pescatori, Edoardo / Borges, Edson / Serefoglu, Ege Can / Saïs-Hamza, Emine / Huyghe, Eric / Ceyhan, Erman / Caroppo, Ettore / Castiglioni, Fabrizio / Bahar, Fahmi / Gokalp, Fatih / Lombardo, Francesco / Gadda, Franco / Duarsa, Gede Wirya Kusuma / Pinggera, Germar-Michael / Busetto, Gian Maria / Balercia, Giancarlo / Cito, Gianmartin / Blecher, Gideon / Franco, Giorgio / Liguori, Giovanni / Elbardisi, Haitham / Keskin, Hakan / Lin, Haocheng / Taniguchi, Hisanori / Park, Hyun Jun / Ziouziou, Imad / de la Rosette, Jean / Hotaling, Jim / Ramsay, Jonathan / Molina, Juan Manuel Corral / Lo, Ka Lun / Bocu, Kadir / Khalafalla, Kareim / Bowa, Kasonde / Okada, Keisuke / Nagao, Koichi / Chiba, Koji / Hakim, Lukman / Makarounis, Konstantinos / Hehemann, Marah / Rodriguez Peña, Marcelo / Falcone, Marco / Bendayan, Marion / Martinez, Marlon / Timpano, Massimiliano / Altan, Mesut / Fode, Mikkel / Al-Marhoon, Mohamed S / Sadighi Gilani, Mohammad Ali / Soebadi, Mohammad Ayodhia / Gherabi, Nazim / Sofikitis, Nikolaos / Kahraman, Oğuzhan / Birowo, Ponco / Kothari, Priyank / Sindhwani, Puneet / Javed, Qaisar / Ambar, Rafael F / Kosgi, Raghavender / Ghayda, Ramy Abou / Adriansjah, Ricky / Condorelli, Rosita Angela / La Vignera, Sandro / Micic, Sava / Kim, Shannon Hee Kyung / Fukuhara, Shinichiro / Ahn, Sun Tae / Mostafa, Taymour / Ong, Teng Aik / Takeshima, Teppei / Amano, Toshiyasu / Barrett, Trenton / Arslan, Umut / Karthikeyan, Vilvapathy Senguttuvan / Atmoko, Widi / Yumura, Yasushi / Yuan, Yiming / Kato, Yuki / Jezek, Davor / Cheng, Bryan Kwun-Chung / Hatzichristodoulou, Georgios / Dy, Jun / Castañé, Eduard Ruiz / El-Sakka, Ahmed I / Nguyen, Quang / Sarikaya, Selcuk / Boeri, Luca / Tan, Ronny / Moussa, Mohamad A / El-Assmy, Ahmed / Alali, Hamed / Alhathal, Naif / Osman, Yasser / Perovic, Dragoljub / Sajadi, Hesamoddin / Akhavizadegan, Hamed / Vučinić, Miroslav / Kattan, Said / Kattan, Mohamed S / Mogharabian, Nasser / Phuoc, Nguyen Ho Vinh / Ngoo, Kay Seong / Alkandari, Mohammad H / Alsuhaibani, Shaheed / Sokolakis, Ioannis / Babaei, Mehdi / King, Mak Siu / Diemer, Thorsten / Gava, Marcelo M / Henrique, Raphael / Silva, Rodrigo Spinola E / Paul, Gustavo Marquesine / Mierzwa, Tiago Cesar / Glina, Sidney / Siddiqi, Kashif / Wu, Han / Wurzacher, Jana / Farkouh, Ala'a / Son, Hwancheol / Minhas, Suks / Lee, Joe / Magsanoc, Nikko / Capogrosso, Paolo / Albano, German Jose / Lewis, Sheena E M / Jayasena, Channa N / Alvarez, Juan G / Teo, Colin / Smith, Ryan P / Chua, Jo Ben M / Jensen, Christian Fuglesang S / Parekattil, Sijo / Finelli, Renata / Durairajanayagam, Damayanthi / Karna, Keshab Kumar / Ahmed, Abdelkareem / Evenson, Don / Umemoto, Yukihiro / Puigvert, Ana / Çeker, Gökhan / Colpi, Giovanni M

    The world journal of men's health

    2022  Volume 41, Issue 1, Page(s) 164–197

    Abstract: Purpose: Varicocele is a common problem among infertile men. Varicocele repair (VR) is frequently performed to improve semen parameters and the chances of pregnancy. However, there is a lack of consensus about the diagnosis, indications for VR and its ... ...

    Abstract Purpose: Varicocele is a common problem among infertile men. Varicocele repair (VR) is frequently performed to improve semen parameters and the chances of pregnancy. However, there is a lack of consensus about the diagnosis, indications for VR and its outcomes. The aim of this study was to explore global practice patterns on the management of varicocele in the context of male infertility.
    Materials and methods: Sixty practicing urologists/andrologists from 23 countries contributed 382 multiple-choice-questions pertaining to varicocele management. These were condensed into an online questionnaire that was forwarded to clinicians involved in male infertility management through direct invitation. The results were analyzed for disagreement and agreement in practice patterns and, compared with the latest guidelines of international professional societies (American Urological Association [AUA], American Society for Reproductive Medicine [ASRM], and European Association of Urology [EAU]), and with evidence emerging from recent systematic reviews and meta-analyses. Additionally, an expert opinion on each topic was provided based on the consensus of 16 experts in the field.
    Results: The questionnaire was answered by 574 clinicians from 59 countries. The majority of respondents were urologists/uro-andrologists. A wide diversity of opinion was seen in every aspect of varicocele diagnosis, indications for repair, choice of technique, management of sub-clinical varicocele and the role of VR in azoospermia. A significant proportion of the responses were at odds with the recommendations of AUA, ASRM, and EAU. A large number of clinical situations were identified where no guidelines are available.
    Conclusions: This study is the largest global survey performed to date on the clinical management of varicocele for male infertility. It demonstrates: 1) a wide disagreement in the approach to varicocele management, 2) large gaps in the clinical practice guidelines from professional societies, and 3) the need for further studies on several aspects of varicocele management in infertile men.
    Language English
    Publishing date 2022-06-13
    Publishing country Korea (South)
    Document type Journal Article
    ZDB-ID 2719786-4
    ISSN 2287-4690 ; 2287-4208
    ISSN (online) 2287-4690
    ISSN 2287-4208
    DOI 10.5534/wjmh.220048
    Database MEDical Literature Analysis and Retrieval System OnLINE

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