Abstract
Introduction: Since the early diagnosis and treatment of varicocele during adolescence can help in reducing the risk of future infertility, finding an appropriate indication is very important in order to avoid unnecessary treatment as well as avoid future infertility. Currently, surgery indications for varicocele in adolescents are including high-grade varicocele and testicular volume loss which there is no relation between these cases and semen parameters.
Objectives: In the current study, the relationship of gonadotropin hormone levels was compared to testicular dysfunction in varicocele patients before and after stimulation by gonadotropin releasing hormone (GnRH).
Patients and Methods: Around 60 patients between 18-30 years old were divided into two groups; patients with normal semen analysis (A) and patients with abnormal semen analysis (B). Hormonal analysis including the measurement of basal luteinizing hormone (LH) and Follicle-stimulating hormone (FSH) (bLH and bFSH) and also measurements of LH and FSH after GnRH stimulation test (sLH and sFSH) were carried out. Data were analyzed using t test by SPSS statistical software.
Results: Of 60 patients, 30 patients had normal semen (group A) and 30 patients had abnormal semen parameters (group B). The bLH in group A was lower than group B and bFSH in group A were more than group B, but there was not a significant difference between them. sLH levels were significantly higher in group A than those of group B and sFSH levels in group B were greater than group A. However the difference was not significant.
Conclusion: Testicular volume loss is not suitable criteria for prediction of testicular dysfunction; GnRH stimulation test has a potential for identifying patients with varicocele that are requiring prophylaxis surgery. Increasing serum levels of LH after stimulation by GnRH can also be applied as a suitable index for prophylaxis surgery in varicocele patients to prevent infertility in future.