Table 1. Main characteristics of the included studies.
| First author | Year | Study design | Varicocele | Varicocele repair | Time to evaluation (mo) | Patients (n) | SDF (%) | MDA (nmol/mL) | ||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Side | Grade | Type | Side | Before | After | Before | After | |||||
| Kavoussi [42] | 2021 | Observational | - | - | MS | - | 3 | 121 | 35.3±11.6 | 19.6±5.3 | ||
| Fathi [43] | 2021 | Observational | - | - | MS | - | 6 | 45 | 34.93±5.56 | 25.75±5.15 | ||
| Abbasi [44] | 2020 | Observational | - | - | MS | - | 3 | 22 | 13.65±11.44 | 10.38±4.64 | ||
| Kamal [45] | 2020 | Observational | - | - | NMI | - | 6 | 34 | 1.9±0.6 | 1.1±0.3 | ||
| Omar [46] | 2020 | Observational | - | - | MS | - | 3 | 100 | 7.7±1.1 | 2.2±0.6 | ||
| Mostafa [47] | 2020 | Observational | - | - | NMI | - | 3 | 30 | 3.4±1.3 | 1.9±0.7 | ||
| Camargo [48] | 2019 | Observational | - | - | MS | - | 12 | 25 | 43.4±22.62 | 32.9±8.87 | ||
| Afsin [49] | 2018 | Observational | - | - | - | - | 12 | 40 | 20.57±4.6 | 15.3±3.63 | ||
| Vahidi [50] | 2018 | Observational | Left | - | MS | - | 3 | 30 | 15.93±4.96 | 10.86±4.44 | ||
| 1 | MS | - | 3 | 5 | 15.4±9.42 | 5.2±1.09 | ||||||
| 2 | MS | - | 3 | 13 | 16±3.39 | 12.07±4.71 | ||||||
| 3 | MS | - | 3 | 12 | 16.08±4.46 | 11.91±3.14 | ||||||
| Sun [51] | 2018 | Observational | Bilateral | - | MS | Bilateral | 12 | 179 | 21.6±7.1 | 11.8±6 | ||
| Left | 12 | 179 | 23±8.1 | 12.1±6.8 | ||||||||
| Lu [52] | 2018 | Observational | Left | - | MS | Left | 6 | 27 | 1.75±0.22 | 0.58±0.06 | ||
| Zaazaa [53] | 2018 | RCT | - | - | MS | - | 3 | 40 | 34.6±4.1 | 28.3±5.2 | ||
| 2 | MS | - | 3 | 14 | 32.7±1.6 | 28±2.3 | ||||||
| 3 | MS | - | 3 | 26 | 35.5±4.7 | 28.5±6.3 | ||||||
| Abdelbaki [54] | 2017 | Observational | - | - | NMI | - | 6 | 55 | 29.49±8.58 | 18.78±7.23 | ||
| Ni [55] | 2016 | Observational | - | 1 | MS | - | 6 | 19 | 23.56±7.55 | 19.54±5.48 | 12.18±4.86 | 8.76±2.73 |
| 2 | MS | - | 6 | 18 | 27.75±9.05 | 22.38±4.54 | 14.12±5.42 | 9.71±2.83 | ||||
| 3 | MS | - | 6 | 14 | 30.03±8.27 | 21.82±5.95 | 15.86±6.78 | 9.5±3.28 | ||||
| Telli [56] | 2015 | Observational | - | - | NMI | - | 3 | 72 | 34.5±3.3 | 28.2±3.5 | ||
| Tavalaee [57] | 2015 | Observational | 1 | - | - | Left | 3 | 23 | 15.9±1.2 | 10.8±1.1 | ||
| Mohammed [58] | 2015 | Observational | - | - | NMI | - | 6 | 75 | 32.4±7.4 | 20±4.1 | ||
| Smit [59] | 2013 | Observational | - | - | - | - | 3 | 49 | 35.2±13.1 | 30.2±14.7 | ||
| Li [60] | 2012 | Observational | - | - | MS | - | 3 | 19 | 28.4±15.6 | 22.4±12.9 | ||
| Gabriel [61] | 2012 | Observational | - | - | MS | - | 4 | 14 | 22.4±11.9 | 12.6±6 | ||
| La Vignera [62] | 2012 | Observational | Left | 3 | MS | Left | 4 | 30 | 5±3 | 2.1±0.4 | ||
| Sadek [63] | 2011 | Observational | Bilateral | - | NMI | - | 3 | 72 | 65.15±20.97 | 51.9±15.2 | ||
| Zini [64] | 2011 | Observational | - | - | MS | - | 4–6 | 25 | 18±11 | 11±6 | ||
| 4 | 19 | 18±11 | 10±5 | |||||||||
| 6 | 19 | 18±11 | 7±3 | |||||||||
| Ghazi [65] | 2011 | Observational | Bilateral | - | MS | Bilateral | 6 | 82 | 21.5±11.2 | 13±14.3 | ||
| Dada [66] | 2010 | Observational | - | - | - | - | 6 | 11 | 60.82±7.12 | 32.58±6.12 | ||
| Nasr Esfahani [67] | 2010 | Observational | - | 3 | - | - | 6 | 70 | 45.69±2.43 | 35.9±2.4 | ||
| Smit [34] | 2010 | Observational | - | - | - | - | 3 | 31a | 35.3±14.3 | 28.6±14.7 | ||
| 18b | 35±11.2 | 33±14.8 | ||||||||||
| Zini [68] | 2005 | Observational | - | - | MS | - | 6 | 37 | 27.7±17.64 | 24.6±16.42 | ||
| Yeşilli [69] | 2005 | Observational | - | - | MS | - | 6 | 26 | 0.61±0.09 | 0.58±0.06 | ||
Values are presented as mean±standard deviation.
MDA: malondialdehyde, MS: microsurgical varicocele repair, NMI: non-microsurgical inguinal varicocele repair, RCT: randomized controlled trial, SDF: sperm DNA fragmentation.
aResponders to varicocele repair (improvement >50% in sperm concentration), bNon-responders to varicocele repair.