VARICOCELE AND INFERTILITY: ETIOPATHOGENESIS AND PATHOGENETIC ASPECTS
Keywords:
Varicocele, male infertility, spermatogenesis, varicocelectomy, spermogram, reactive oxygen species, oxidative stress, sperm DNA fragmentation, immunoinflammatory mechanisms of infertility, microbiome, microRNA, assisted reproductive technologies, pregnancy, reproductive outcomes.Abstract
Male infertility is a significant medical and social problem affecting a considerable proportion of married couples of reproductive age. Varicocele is one of the leading causes of male infertility and is considered the most common pathology that can potentially be corrected surgically. Currently, varicocelectomy remains the only intervention proven to restore sperm in the ejaculate in some patients and improve key parameters of spermatogenesis. Despite the accumulated clinical data, the pathogenesis of varicocele is multifactorial and includes haemodynamic disorders, heat stress, hypoxia, and immunoinflammatory processes. Particular importance is attached to oxidative stress caused by an excess of active oxygen species, which can damage sperm membranes and increase DNA fragmentation. Sperm DNA fragmentation is considered a promising marker that influences the likelihood of natural conception and the effectiveness of assisted reproductive technologies.
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