Molecular and other predictors for infertility in patients with varicoceles

摘要: Varicoceles are a treatable cause of male infertility, but very clinically diverse. Both histologic and molecular changes occur in the testes men with varicocele. Physical measurements (scrotal temperature, testicular volume, pressure within pampiniform plexus, basal lamina thickness) correlate prognosis, these correlations have not been accepted as predictors successful repair because variation patient populations. Conventional semen parameters similarly correlate, apply only to >5 x106 sperm/ejaculate. Levels toxicants (e.g. norepinephrine, cadmium), reactive oxygen species byproducts, hormones, their receptors modulators evaluated small-scale studies. Medical therapies (antoxidants, anti-inflammatories hormones) applied empirically small groups patients positive results that verified large-scale trials. Thus, urologists still face challenge determine which will benefit from varicocelectomies and/or medical interventions. In this review we summarize our current understanding pathophysiology varicoceles, discuss some new findings may be applicable specific clinical situations.