Beneficial Effect of Microsurgical Varicocelectomy is Superior for Men With Bilateral Versus Unilateral Repair
Bibliographic record
Abstract
PURPOSE: Varicocele represents the most common correctable cause of male infertility, and most reports indicate that varicocelectomy has a beneficial effect on male fertility and pregnancy outcome. Little is known about the differential effect of bilateral, compared to unilateral varicocelectomy, on male fertility potential. MATERIALS AND METHODS: A total of 369 consecutive varicocelectomies were performed for male factor infertility between July 1996 and July 2002. The outcomes measured include postoperative changes in semen parameters, pregnancy rates (assisted and unassisted) and use of assisted reproductive technology (intrauterine insemination and in vitro fertilization with intracytoplasmic sperm injection). RESULTS: There were 157 men who underwent bilateral and 212 who underwent unilateral left varicocelectomy. Both groups had comparable male and female ages, and baseline semen parameters. Semen parameters improved significantly after surgery in the bilateral and unilateral groups. Moreover, the improvement in percent motility was significantly greater in the bilateral compared to the unilateral group (8.0% +/- 1.7% compared to 4.4% +/- 1.5% improvement, respectively, p <0.01). In addition, the spontaneous pregnancy rate was significantly higher in the bilateral compared to the unilateral group (49% vs 36%, respectively, p <0.05). Assisted reproductive technology was comparable in the unilateral and bilateral groups (64% vs 51%, respectively, p >0.05). CONCLUSIONS: Our data indicate that bilateral varicocelectomy (for clinically palpable bilateral varicoceles) is associated with a significantly greater improvement in sperm quality (motility) and male fertility potential than unilateral varicocelectomy. The greater improvement in semen parameters and pregnancy outcome associated with bilateral varicocelectomy support the concept of a detrimental dose-effect of varicocele on male fertility potential.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".