Development Of A New Model For Predicting Sperm Progressive Motility Following Microsurgical Varicocele Correction

Objective: To develop a novel series of predictive models based on color Doppler ultrasound for prediction of sperm progressive motility in patients after microsurgical varicocelectomy.Methods: Between July 2017 and July 2019,101 patients underwent microsurgical varicocelectomy at Shengjing Hospital of China Medical University.Spermatic cord color ultrasound images were processed using ImageJ 1.51 software to obtain the mean reflux depth of blood flow signals,which reflect the degree of spermatic vein regurgitation.Additionally,the clinical data of all patients were recorded.An increase in sperm progressive motility > 0 following varicocelectomy was defined as an improvement.The Kolmogorov-Smirnov,Student’s t-,Mann-Whitney U,chi-square tests,and univariate analysis and multivariate regression model were used to construct a nomogram-based predictive model.Results: The predictive factors in this model include mean reflux depth,testosterone levels,and baseline sperm progressive motility.The model exhibited a good degree of discrimination,with an AUROC of 0.761(95% CI: 0.668-0.854)and good calibration(unreliability test p= 0.983).Decision curve analysis confirmed the clinical utility of the model.Conclusions: In this study,a nomogram that can be used before surgery to evaluate whether sperm progressive motility is improved after surgery in patients with varicocele is proposed for guiding clinical treatment.We studied patients underwent microsurgical varicocelectomy.And we found that patients with shallow spermatic vein depth,higher preoperative testosterone levels,and lower BPM seem to benefit more from the surgery.