Evidence map›Paper›PMID 40444428›Full record

Observational studyAndrology2026

Comparative efficacy of varicocelectomy and intrauterine insemination in varicocoele patients with mild semen abnormalities: An observational study.

Yanlin Ma, Weiming Deng, Tingting Wu, Qi Li, Yuanjie Li, Wenjie Mai, Lizheng Yan, Changwei Liang, Lingxiao Zhang

Abstract readObservational StudyComparative StudyMulticenter Study
In one paragraph

Observational study in Andrology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Yanlin MaDepartment of Reproductive Medicine, The First Affiliated Hospital of Hainan Medical University, Haikou, China.
Weiming DengDepartment of Urology, The First Affiliated Hospital of University of South China, Hengyang, Hunan Province, China.
Tingting WuDepartment of Reproductive Medicine, The First Affiliated Hospital of Hainan Medical University, Haikou, China.
Qi LiHainan Modern Women and Children's Hospital, Reproductive Medicine, Haikou, Hainan, China.
Yuanjie LiDepartment of Urology, Honghuagang District People's Hospital, Zunyi City, Guizhou Province, China.
Wenjie MaiDepartment of Urology, Sanya People's Hospital, Sanya City, Hainan Province, China.
Lizheng YanDepartment of Reproductive Medicine, The First Affiliated Hospital of Hainan Medical University, Haikou, China.
Changwei LiangDepartment of Urology, Hainan Western Central Hospital, Danzhou City, Hainan Province, China.
Lingxiao ZhangDepartment of Reproductive Medicine, The First Affiliated Hospital of Hainan Medical University, Haikou, China.ORCID 0009-0004-1892-5076

Funding

Hainan Province Clinical Medical CenterHainan Province Science and Technology Special Fund ZDYF2022SHFZ312Innovation Platform for Academicians of Hainan Province SQ2022PTKY0015The Health Research Project of Hunan Provincial Health Commission 20232430
6 · The paper itself

Abstract

backgroundVaricocoele is a common cause of male infertility, affecting spermatogenesis through increased testicular temperature, venous stasis, and oxidative stress. Microsurgical subinguinal varicocelectomy improves semen quality, whereas intrauterine insemination is widely used for mild male factor infertility. The comparative efficacy of these treatments in varicocoele patients with mild semen abnormalities remains unclear.

objectivesTo evaluate the efficacy of microsurgical subinguinal varicocelectomy and intrauterine insemination in improving clinical pregnancy and live birth rates in varicocoele patients with mild semen abnormalities and assess post-operative improvements in semen parameters following microsurgical subinguinal varicocelectomy. MATERIALS AND

methodsA retrospective cohort study involving 650 microsurgical subinguinal varicocelectomy patients from five medical centers and 700 intrauterine insemination patients from one center was conducted. Inclusion criteria included varicocoele diagnosed via ultrasonography, mild semen abnormalities (total motile sperm count ≥5 million), and at least one abnormal semen parameter. Primary outcomes were clinical pregnancy and live birth rates. Secondary outcomes included sperm concentration, motility, and total motile sperm count changes post-microsurgical subinguinal varicocelectomy. Statistical analyses included chi-square tests and logistic regression.

resultsMicrosurgical subinguinal varicocelectomy patients demonstrated significant improvements in sperm concentration (35.2-43.3 × 10⁶/mL), motility (26%-38%), and total motile sperm count (18.8-34.9 × 10⁶, p < 0.001). Clinical pregnancy and live birth rates were higher in the microsurgical subinguinal varicocelectomy group (35.23% and 31.08%) compared to the intrauterine insemination group (29.57% and 24.00%, p < 0.05). Multivariate analysis revealed that microsurgical subinguinal varicocelectomy significantly increased pregnancy (OR = 1.43, 95% CI: 1.12-1.83, p < 0.05) and live birth rates (OR = 1.56, 95% CI: 1.21-2.02, p < 0.05). DISCUSSION AND

conclusionMicrosurgical subinguinal varicocelectomy significantly enhances semen quality and achieves superior clinical pregnancy and live birth rates compared to intrauterine insemination for varicocoele patients with mild semen abnormalities. These findings suggest that microsurgical subinguinal varicocelectomy is a more effective treatment option, highlighting the importance of individualized treatment strategies and supporting the preferential use of surgical intervention in this specific patient population.

Indexed as

Infertility, MaleInsemination, ArtificialVaricoceleAdultFemaleHumansMaleMicrosurgeryPregnancyPregnancy RateRetrospective StudiesSemen AnalysisSperm CountSperm MotilityTreatment Outcomeintrauterine insemination (IUI)mild semen abnormalitiespregnancy outcomesvaricocelectomyvaricocoele

Identifiers

PMID40444428
PMCPMC12842849

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.