https://doi.org/10.4081/aiua.2024.12545

Can serum 17-hydroxy progesterone predict an improvement in semen parameters following micro-varicocelectomy? A prospective study

Vol. 96 No. 3 (2024)
Submitted: April 5, 2024
Accepted: May 3, 2024
Published: October 2, 2024
Sub-inguinal micro-varicocelectomy, 17 hydroxy progesterone, total testosterone, sperm count, progressive sperm motility, abnormal sperm forms
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Authors

Mohamed Wael Ragab
https://orcid.org/0000-0001-6139-7513
Department of Andrology & STDs, Kasr Alainy Faculty of Medicine, Cairo University, Egypt.
Mohamed Abbas
Department of Andrology & STDs, Kasr Alainy Faculty of Medicine, Cairo University, Egypt.
Tarek Ramzy
Department of Chemical Pathology, Kasr Alainy Faculty of Medicine, Cairo University, Egypt.
Sameh Fayek GamalEl Din
samehfayek@kasralainy.edu.eg
https://orcid.org/0000-0003-1918-5132
Department of Andrology & STDs, Kasr Alainy Faculty of Medicine, Cairo University, Egypt.
Mohamed Yousry Elamir
Department of Andrology & STDs, Kasr Alainy Faculty of Medicine, Cairo University, Egypt.
Mohammed H. Alkandari
Mubarak Al-Kabeer Teaching Hospital, Jabriya, Kuwait.
Abdullah Salem Alshammari
https://orcid.org/0000-0001-5994-3394
Farwaniyah Hospital, Kuwait City, Al Farwaniyah Governorate, Kuwait.
Mohamed Ragab Shehata
Department of Andrology & STDs, Kasr Alainy Faculty of Medicine, Cairo University, Egypt.
Ashraf Zeidan
Department of Andrology & STDs, Kasr Alainy Faculty of Medicine, Cairo University, Egypt.

Background & objectives: Notably, 17-hydroxy progesterone (17-OHP) (17-OHP) is a precursor for testosterone (T) synthesis, and intratesticular testosterone (ITT) is essential for spermatogenesis. Varicocele (Vx) has an estimated prevalence of 15% in the general population and 35% in those with primary infertility. We aimed to evaluate the correlation between changes of serum 17-OHP after sub-inguinal micro-varicocelectomy and improvement of semen parameters.
Patients and methods: The current prospective study included 45 infertile men attending the andrology clinic form February 2021 to August 2021. Two semen analyses and hormonal profile were evaluated. Colored duplex ultasonography (CDUS) was done in standing and supine position for accurate measurements of testicular volumes and confirmation of Vx. Patients underwent sub-inguinal micro-varicocelectomy using a surgical microscope HB surgitech. We followed them prospectively up for three months following micro-varicocelectomy with serum TT and 17-OHP.
Results: Sperm concentration improved significantly from 8.36 ± 5.04 million/ml to 12.52 ± 8.42 million/ml after 3 months following sub-inguinal micro-varicocelectomy (p= 0.001), with normalization of concentration in 15/45 (33%) patients. Total motility did not improve significantly but progressive motility improved significantly from 8.62 ± 8.74% to 16.24 ± 14.45% (p=0.001). Abnormal forms significantly declined from 96.67 ± 2.03% to 95.75 ± 2.47% (p=0.009).  Serum 17 OHP and 17 OHP/total testosterone (TT) improved significantly from 1.21 ± 0.45 ng/ml and 0.26 ± 0.09 to 1.42 ± 0.76 ng/ml and 0.3 ± 0.16 (p= 0.013, p= 0.004), respectively, while serum TT did not improve significantly. A significant correlation was found between improvement in sperm concentration and both serum 17 OHP and 17 OHP/TT ratio (p=0.001, p=004). Furthermore, change in abnormal sperm forms showed significant correlations with changes in both 17-OHP and 17-OHP/TT.
Conclusion: 17 OHP and 17OHP/ TT ratio can be used as biomarkers to detect improvement in semen parameters following sub-inguinal micro-varicocelectomy.

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How to Cite

Ragab, M. W., Abbas, M., Ramzy, T., GamalEl Din, S. F., Elamir, M. Y., Alkandari, M. H., Alshammari, A. S., Shehata, M. R., & Zeidan, A. (2024). Can serum 17-hydroxy progesterone predict an improvement in semen parameters following micro-varicocelectomy? A prospective study. Archivio Italiano Di Urologia E Andrologia, 96(3). https://doi.org/10.4081/aiua.2024.12545
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