Table 5.
Included studies of VR for severe OAT: design, levels of evidence, and four sets of outcomes*.
| Study | Design (LoE) | Sperm Outcomes |
Hormonal Outcomes |
Fertility Outcomes |
|||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| Count | Motility | Morph | FSH | LH | IB | TT | TV | PR | LBR | ||
| Poulakis 2006 [35]a | Rp (III) | + | + | + | + | T 33.3%; Sp 21.2%; ART 12.1% | T 33.3%; Sp 21.2%; ART 12.1% | ||||
| Ishikawa 2008 [36]b | Case-control (III) | + | = | = | = | = | = | Sp 7.4% | |||
| Smit 2010 [37]c | Rp (III) | T + | T + | T = | R =, NR— | R =, NR — | = | = | Sp 37%; ART 22% | ||
| Ghanem 2011 [34]d | Rp (III) | + | + | + | + | + | = | = | Sp 15% (9/59); ICSI 32.3% (10/31); IVF 22.2% (2/9); IUI 14.3(1/7)% |
Sp 15%; ICSI 29%; IVF 22%; IUI 14% |
|
| Leung 2013 [38]e | Case series (IV) | + | + | + | T 75% (12/16); Sp 41.7% (5/12); IUI 8.3%% (1/12); IVF 50% (6/12) |
||||||
| Enatsu 2014 [13]f | Rp (III) | T +, R +, NR = |
T +, R +, NR = |
= | = | = | Sp: T 17.6% (18/102); R 15.6% (16/102); NR 2% (2/102) | ||||
| Dubin 2018 [11]g | Rp (III) | + | + | Sp 10% (1/10); IUI 28.6% (2/7) | |||||||
| Gupta 2018 [39]h | Rp (III) | + | + | Sp 37.1% | |||||||
| Almekaty 2019 [40]i | Prospective randomized study (II) | G1 + G2 + |
G1 + G2 + |
G1 +, G2 = |
Sp. G1 40%; G2 30% | ||||||
| Najari 2019 [41]j | Case Report (V) | + | + | + | + | ART 100% | ART 100% | ||||
| Turgut 2020 [42]j | Rp (III) | + | + | + | Sp 13.4%; ART 24.9% | ||||||
| Addar 2021 [18] | Rp (III) | +k | — | ||||||||
| Majzoub 2021 [9]l | Rp (III) | + | + | = | = | = | = | ||||
| Vu Tan 2023 [43] | Prospective non controlled (III) | + | + | +m | Sp 100% | ||||||
| Alkhayal 2024 [44]n | Rp (III) | + | = | = | 100% (5/5)o | 20% (1/5) p | |||||
Due to space considerations, only the first author is cited; empty cells denote data not available/cannot be extracted; *Levels of evidence grading based on Dang et al. (2021) [68] and Clinical Information Access Portal (Undated, c2018) [69]; +: significant improvement (p < 0.05); =: no significant change (p > 0.05); —: significant deterioration (p < 0.05); ART: Assisted reproductive technology; FSH: Follicle stimulating hormone; G: Group; IB: Inhibin B; ICSI: Intracytoplasmic sperm injection; IUI; Intrauterine insemination; IVF: In vitro fertilization; LBR: Live birth rate; LH: Luteinizing hormone; Morph: morphology; OAT: Oligoasthenoteratozoospermia; PR: Pregnancy rate; Rp: Retrospective; Sp: Spontaneous pregnancy; T: Total; TT: Testosterone; TV: Testicular volume; Only those with sperm concentration < 5 million/ml included in the table representing: a70.2%, b90%, e36.4%, h62.5%, n38.5% of the sample; cR (responders) comprised 63.2% of the sample, NR (non-responders) comprised 36.8% of sample; d Retrospective design with controls; fR (responders), 41.1% of sample; NR (non-responders), 58.9% of sample; gProspectively collected data, no controls; iG1: artery-preserving varicocelectomy (49.7% of sample), G2: artery ligation varicocelectomy (50.3% of sample); jStudy did not provide p value, significance could not be determined; k8.9% of sample showed deterioration; l Comprises original study and meta-analysis, only the findings of original study included in the table; mPercentage of improvement cannot be computed as initial value was zero; oNot reported whether pregnancies were spontaneous or assisted; p Not reported whether live births were after spontaneous or assisted pregnancies.