Microsurgical Varicocelectomy Versus No Surgery in Men With a Palpable Varicocele and an Abnormal Semen Analysis

Status:	Archived
Conditions:	Women's Studies, Infertility
Therapuetic Areas:	Reproductive
Healthy:	No
Age Range:	Any
Updated:	7/1/2011
Start Date:	May 2010
End Date:	May 2013

A Prospective, Randomized, Study of Microsurgical Varicocelectomy Versus Observation in the Treatment of Male Partners With a Palpable Varicocele and an Abnormal Semen Analysis

The primary research hypothesis is that microsurgical varicocelectomy will result in an
increase in live birth in infertile couples where the male partner has a palpable varicocele
and an abnormal semen analysis in comparison to male partners who do not have microsurgical
varicocelectomy.

The secondary hypotheses include:

1. To assess whether up to 4 cycles of intrauterine insemination confers any additional
increase in live birth rates compared to timed intercourse;

2. To examine spousal pregnancy rate as the secondary outcome; and

3. To study the effect of varicocelectomy in men with infertility, an abnormal semen
analysis, and a palpable varicocele on

- Testicular semen analysis parameters;

- Serological measures of FSH, LH, total and free testosterone and

- Measures of quality of life and sexual function in both partners.

Study Design

This will be a randomized controlled clinical trial to examine the effect of varicocelectomy
in men with infertility, an abnormal semen analysis, and a palpable varicocele. This
approach will allow us to compare (i) the effect of microsurgical varicocelectomy on live
birth rates after up to four cycles of alternating intrauterine insemination and four cycles
of timed intercourse over 8 months and (ii) the relative effectiveness of intrauterine
insemination versus timed intercourse on live birth rates. Secondary analyses will explore
the effect of the surgical intervention on pregnancy rates, semen analysis parameters,
serological hormonal measures in the male subjects, and quality of life measures in both the
male and female partners.

Treatment

Two hundred and thirty-two couples will be randomized to the two intervention groups
(microsurgical varicocelectomy plus up to four cycles each of alternating intrauterine
insemination and timed intercourse or no microsurgical varicocelectomy plus up to four
cycles each of alternating intrauterine insemination and timed intercourse).

Timing

We anticipate that it will take 3 years to complete the study. Enrollment will begin in year
1 of the study. 34 couples will need to be recruited per site over the duration of the study
to reach the enrollment goal of 232 couples. Participants will be enrolled in the study for
one year, with the male partner undergoing periodic study assessments at two month
intervals.

We found this trial at

sites

Yale University School of Medicine

333 Cedar St
New Haven, Connecticut 06504

(203) 432-4771