Study On Correlation Between Varicocele And Semen Detection Index

BackgroundVaricocele（VC）is a vascular disease caused by obstruction of the internal spermatic venous plexus caused by various factors and it is one of the main causes of male infertility.Clinical studies have shown that VC and some behavioral factors（such as smoking,drinking,staying up late,etc.）can cause changes in semen quality and then cause infertility.Therefore,separating analysis of the influence of VC on semen quality excluding the influence of common behavioral factors on semen quality that can more accurately evaluate the relationship between VC and infertility.But there are few relevant studies about that.The main indexes of male fertility were semen concentration,percentage of forward motile Sperm,percentage of sperm with normal morphology and Sperm DNA fragmentation index（DFI）.DFI studies semen at the molecular level and reflecting the degree of DNA damage inside the sperm as a new semen detection indicator.The diagnostic value of DFI for male infertility and its correlation with other semen detection indicators have also become a research hotspot.ObjectiveBy analyzing the characteristics of semen concentration,percentage of forward motile sperm,percentage of sperm with normal morphology and DFI in patients with VC,the diagnostic value of VC indicators is understood,the value of each index in the diagnosis of VC was understood,so as to provide more sensitive and specific evaluation indexes for the early diagnosis and treatment of VC in clinic and contribute to the early diagnosis of male infertility.Methods1.Research objects:Semen examination and questionnaire were conducted for patients who visited the Male Reproductive Health Department of Luoyang Maternal and Child Health Hospital from May to October 2021.A total of 223 subjects were eligible for shortlisting from 20 to 35 years old,with an average age of（30.93±2.94）years old.They were grouped according to the influence of behavioral factors on semen.The influence of behavioral factors on semen quality was not excluded.According to whether there was VC,they were divided into experimental group and control group,the experimental group had70 cases（with VC）,and the control group had 153 cases（without VC）.Excluding the influence of behavioral factors on semen quality,according to whether VC and bad behavior habits were divided into experimental group and control group,41 cases in the experimental group（with VC and no bad behavior habits）,50 cases in the control group（without VC and no bad behavior habits）.2.Experimental methods:Computer assisted sperm analysis（CASA）technique was used to detect semen concentration and percentage of forward movement and percentage of sperm with normal morphology.The sperm morphology staining method was Diff-Quik staining.The sperm chromatin structure analysis assay（SCSA）method was used to detect sperm DFI by BD flow cytometer.3.Statistical methods:The statistical analysis software was SPSS25.0.that using independent sample t test or Mann-Whitney U test to compare the semen concentration,forward motile sperm percentage,percentage of sperm with normal morphology and DFI of the two groups.The influencing factors of VC were analyzed by Logistic regression.The diagnostic efficiency of VC was judged by drawing ROC curve.Spearman correlation was used to test the correlation between semen indicators.P<0.05 test level indicated that the difference was statistically significant.Results1.The influence of other behavioral factors on semen cannot be ruled outThere was no significant difference in age between VC group and non-VC group（P>0.05）.Semen concentration:VC group was lower than non-VC group[26.85（11.70,44.20）vs51.70（30.40,83.70）]×10~6/m L.The percentage of forward motile sperm:VC group was lower than that non-VC group（20.55±11.88vs37.09±12.25）%.The percentage of sperm with normal morphology:VC group was lower than non-VC group[4.40（3.50,4.90）vs 4.90（4.40,5.70）]%.DFI:VC group was higher than non-VC group[19.23（13.03,33.54）vs9.94（6.51,14.77）]%.and the differences were statistically significant（P<0.05）.2.The effect of other behavioral factors on semen was excluded（1）There was no significant difference in age between VC group and non-VC group（P>0.05）.Semen concentration:VC group was lower than non-VC group[28.60（15.50,43.70）vs74.60（41.50,101.90）]×10~6/m L.The percentage of forward motile sperm:VC group was lower than that non-VC group（20.45±13.41 vs 35.91±10.90）%.The percentage of sperm with normal morphology:VC group was lower than non-VC group[4.30（3.30,4.80）vs 5.18（4.60,6.30）]%.DFI:VC group was higher than non-VC group[21.40（12.50,33.54）vs11.77（6.32-15.83）]%.The differences were statistically significant（P<0.05）.（2）Multiple logistic regression analysis showed that semen concentration（0R=0.952,95%CI:0.925-0.980,P<0.05）and percentage of forward motile sperm（0R=0.918,95%CI:0.855-0.985,P<0.05）were independent protective factors for VC.DFI（0R=1.102,95%CI:1.008-1.203,P<0.05）was an independent risk factor for VC.The percentage of normal sperm（P>0.05）was not an independent factor of VC.（3）The diagnostic efficiency of various indicators for VC was observed,and the highest AUC of VC detected by the combination of four indicators was 0.950.（4）DFI was negatively correlated with semen concentration,percentage of forward motile sperm and percentage of normal sperm（r=-0.246,-0.532,-0.287,P<0.05）.conclusion1.This study found that VC can cause male infertility and causing sperm DNA damage.2.The various test indexes of semen were jointly tested for VC and that can provide a good basis for clinical screening and treatment of VC patients.3.DFI is an important indicator for evaluating male fertility.