Varicocele and male fertility. TEM and FISH in spermatozoa from patients with varicocele

Varicocele plays a detrimental role in fertility as demonstrated by the presence of a higher frequency of affected men among the infertile population than among men with normal sperm parameters. In this study the ejaculates from a large group of selected men affected by varicocele were examined by light and transmission electron microscopy (TEM). The effect of varicocele on chromosome meiotic segregation was examined directly on sperm nuclei by fluorescence in situ hybridization (FISH). The potential benefits of varicocelectomy on sperm quality were evaluated by analyzing sperm characteristics before and after surgical correction of varicocele. TEM analysis highlighted that in varicocele group the incidence of sperm pathologies such as immaturity, apoptosis, and necrosis was higher than in the control group. The study of meiotic segregation in varicocele patients showed that the mean frequencies of disomies and diploidies were out of the normal range. A general improvement in semen quality was observed after varicocele repair. In conclusion, varicocele has a negative effect on sperm structure and function, and on meiotic segregation. Taking into account these data, it is advisable to perform TEM and FISH analyses to all varicocele patients.