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Pros: Should Sperm DNA Fragmentation Testing Be Used in Men with Varicocele?

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Varicocele and Male Infertility

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Abstract

Varicocele repair (VR) has been a mainstay of treatment for male factor infertility for decades. Many males have varicoceles but identifying those who would benefit most from varicocele repair is challenging. This challenge has become more significant with the advent of assisted reproductive technologies (ART), when patients readily proceed to intrauterine insemination (IUI), in vitro fertilization (IVF), or intracytoplasmic sperm injection (ICSI), even with suboptimal semen parameters. In this chapter, we argue that infertile couples with a male partner having a varicocele will benefit from varicocele repair, prior to proceeding to any form of ART. VR may eliminate the need for ART in some couples, and for those couples who still require ART after VR, repair improves success rates by improving sperm counts and quality and is cost-effective.

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Acknowledgments

The authors would like to thank Christopher R.V. Hoover, MD (Gallup, NM), for creating and kindly providing the figures included in this chapter.

This work is supported in part by NIH grants K12 DK0083014, the Multidisciplinary K12 Urologic Research (KURe) Career Development Program awarded to DJL (NT is a K12 Scholar) and R01DK078121 from the National Institute of Kidney and Digestive Diseases to Dolores J Lamb. Alexander W. Pastuszak is supported by a K08 Mentored Career Development Award from the National Institute of Kidney and Digestive Diseases (DK115835-01). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

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Authors and Affiliations

  1. Urology Institute, University Hospital / Case Western Reserve University, Cleveland, OH, USA

    Nannan Thirumavalavan

  2. Division of Male Reproductive Medicine and Surgery, Scott Department of Urology, Baylor College of Medicine, Houston, TX, USA

    Joseph Scott Gabrielsen

  3. Department of Surgery, Division of Urology, University of Utah School of Medicine, Salt Lake City, UT, USA

    Alexander W. Pastuszak

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  1. Nannan Thirumavalavan
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  2. Joseph Scott Gabrielsen
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  3. Alexander W. Pastuszak
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Correspondence to Nannan Thirumavalavan .

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Editors and Affiliations

  1. ANDROFERT, Andrology & Human Reproduction Clinic, Campinas, São Paulo, Brazil

    Sandro C Esteves

  2. S.H. Ho Urology Centre, Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, Hong Kong

    Chak-Lam Cho

  3. Department of Urology, Hamad Medical Corporation, Weill Cornell Medicine Qatar, Doha, Qatar

    Ahmad Majzoub

  4. Department of Urology, Cleveland Clinic, Cleveland, OH, USA

    Ashok Agarwal

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Thirumavalavan, N., Gabrielsen, J.S., Pastuszak, A.W. (2019). Pros: Should Sperm DNA Fragmentation Testing Be Used in Men with Varicocele?. In: Esteves, S., Cho, CL., Majzoub, A., Agarwal, A. (eds) Varicocele and Male Infertility. Springer, Cham. https://doi.org/10.1007/978-3-319-79102-9_42

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  • DOI: https://doi.org/10.1007/978-3-319-79102-9_42

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