Severity of testicular varicocele and sperm cell ultramorphologic characteristics

Ultramorphologic characteristics of sperm cells found in infertile men with varicoceles were compared with the severity of the varicocele. Classification of varicoceles into mild, moderate or marked was determined by spermatic vein diameter and degree of blood reflux. These were evaluated by high resolution duplex sonography. There were no statistical differences between the 3 grades of varicocele severity with regard to abnormalities in the subcellular organelles of the acrosome, karyoplasm, and skeleton of spermatozoal heads, or in the axoneme, outer dense fiber and skeleton of sperm cell tails. The only abnormal ultramorphologic features found to be significant among the 3 groups were differences in the frequencies of karyoplasm agenesis, and of partial agenesis, malformation and degeneration of the acrosome in sperm cell heads. However, these features could not be related to grade of severity and therefore, no ultramorphologic severity pattern could be detected. Thus, no varicocele beneficial score based on grade of severity and sperm cell ultramorphology can be suggested for clinical use.