Predictability of varicocele repair success: preliminary results of a machine learning-based approach.


Journal

Asian journal of andrology
ISSN: 1745-7262
Titre abrégé: Asian J Androl
Pays: China
ID NLM: 100942132

Informations de publication

Date de publication:
09 Aug 2024
Historique:
received: 03 02 2024
accepted: 07 05 2024
medline: 9 8 2024
pubmed: 9 8 2024
entrez: 9 8 2024
Statut: aheadofprint

Résumé

Varicocele is a prevalent condition in the infertile male population. However, to date, which patients may benefit most from varicocele repair is still a matter of debate. The purpose of this study was to evaluate whether certain preintervention sperm parameters are predictive of successful varicocele repair, defined as an improvement in total motile sperm count (TMSC). We performed a retrospective study on 111 patients with varicocele who had undergone varicocele repair, collected from the Department of Endocrinology, Metabolic Diseases and Nutrition, University of Catania (Catania, Italy), and the Unit of Urology at the Selcuk University School of Medicine (Konya, Türkiye). The predictive analysis was conducted through the use of the Brain Project, an innovative tool that allows a complete and totally unbiased search of mathematical expressions that relate the object of study to the various parameters available. Varicocele repair was considered successful when TMSC increased by at least 50% of the preintervention value. For patients with preintervention TMSC below 5 × 106, improvement was considered clinically relevant when the increase exceeded 50% and the absolute TMSC value was >5 × 106. From the preintervention TMSC alone, we found a model that predicts patients who appear to benefit little from varicocele repair with a sensitivity of 50.0% and a specificity of 81.8%. Varicocele grade and serum follicle-stimulating hormone (FSH) levels did not play a predictive role, but it should be noted that all patients enrolled in this study were selected with intermediate- or high-grade varicocele and normal FSH levels. In conclusion, preintervention TMSC is predictive of the success of varicocele repair in terms of TMSC improvement in patients with intermediate- or high-grade varicoceles and normal FSH levels.

Identifiants

pubmed: 39118538
doi: 10.4103/aja202438
pii: 00129336-990000000-00218
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2024 Copyright: ©The Author(s)(2024).

Références

Agarwal A, Mulgund A, Hamada A, Chyatte MR. A unique view on male infertility around the globe. Reprod Biol Endocrinol 2015;13:37
Clavijo RI, Carrasquillo R, Ramasamy R. Varicoceles: prevalence and pathogenesis in adult men. Fertil Steril 2017;108:364–9
Chiba K, Fujisawa M. Clinical outcomes of varicocele repair in infertile men: a review. World J Mens Health 2016;34:101–9
Zampieri N, Zamboni C, Ottolenghi A, Camoglio FS. The role of lifestyle changing to improve the semen quality in patients with varicocele. Minerva Urol Nefrol 2008;60:199–204
Calogero AE, Fiore M, Giacone F, Altomare M, Asero P, et al. Exposure to multiple metals/metalloids and human semen quality: a cross-sectional study. Ecotoxicol Environ Saf 2021;215:112165
Cannarella R, Gül M, Rambhatla A, Agarwal A. Temporal decline of sperm concentration: role of endocrine disruptors. Endocrine 2023;79:1–16
Shah R, Agarwal A, Kavoussi P, Rambhatla A, Saleh R, et al. Consensus and diversity in the management of varicocele for male infertility: results of a global practice survey and comparison with guidelines and recommendations. World J Mens Health 2023;41:164–97
Jensen CF, Østergren P, Dupree JM, Ohl DA, Sønksen J, et al. Varicocele and male infertility. Nat Rev Urol 2017;14:523–33
Marks JL, McMahon R, Lipshultz LI. Predictive parameters of successful varicocele repair. J Urol 1986;136:609–12
Rodriguez Peña M, Alescio L, Russell A, Lourenco da Cunha J, Alzu G, et al. Predictors of improved seminal parameters and fertility after varicocele repair in young adults. Andrologia 2009;41:277–81
Samplaski MK, Yu C, Kattan MW, Lo KC, Grober ED, et al. Nomograms for predicting changes in semen parameters in infertile men after varicocele repair. Fertil Steril 2014;102:68–74
Kandevani NY, Namdari F, Hamidi M, Dialameh H, Behzadi A. Developing a novel prediction model for the impact of varicocelectomy on postoperative fertility. Eur J Transl Myol 2022;32:10411
Chen J, Remulla D, Nguyen JH, Dua A, Liu Y, et al. Current status of artificial intelligence applications in urology and their potential to influence clinical practice. BJU Int 2019;124:567–77
Ory J, Tradewell MB, Blankstein U, Lima TF, Nackeeran S, et al. Artificial intelligence based machine learning models predict sperm parameter upgrading after varicocele repair: a multi-institutional analysis. World J Mens Health 2022;40:618–26
Russo M. A distributed neuro-genetic programming tool. Swarm Evol Comput 2016;27:145–55
Russo M. A novel technique to self-adapt parameters in parallel/distributed genetic programming. Soft Comput 2020;24:16885–94
Buccheri E, Dell'Aquila D, Russo M. Artificial intelligence in health data analysis: the Darwinian evolution theory suggests an extremely simple and zero-cost large-scale screening tool for prediabetes and type 2 diabetes. Diabetes Res Clin Pract 2021;174:108722
Dell'Aquila D, Gnoffo B, Lombardo I, Porto F, Russo M. Modeling heavy-ion fusion cross section data via a novel artificial intelligence approach. J Phys G Nucl Part Phys 2023;50:015101
Hamilton JA, Cissen M, Brandes M, Smeenk JM, de Bruin JP, et al. Total motile sperm count: a better indicator for the severity of male factor infertility than the WHO sperm classification system. Hum Reprod 2015;30:1110–21
Dubin L, Amelar RD. Varicocele size and results of varicocelectomy in selected subfertile men with varicocele. Fertil Steril 1970;21:606–9
Sarteschi M, Paoli R, Bianchini M, Fabris GFM The echo-color-Doppler in the study of varicocele. G Ital Ultrasonologia 1993;4:43–9
World Health Organization. WHO Laboratory Manual for the Examination and Processing of Human Semen. 5th ed. Geneva: World Health Organization;2010
Mirilas P, Mentessidou A. Microsurgical subinguinal varicocelectomy in children, adolescents, and adults: surgical anatomy and anatomically justified technique. J Androl 2012;33:338–49
Bähren W, Biehl C, Danz B. Failed sclerotherapy trials with the V. spermatica interna. A retrospective analysis in 1141 patients with idiopathic varicocele. Rofo 1992;157:355–60
Basile A, Failla G, La Vignera S, Condorelli RA, Calogero A, et al. Left spermatic vein retrograde sclerosis: comparison between sclerosant agent injection through a diagnostic catheter versus through an occluding balloon catheter. Radiol Med 2015;120:483–8
Wang Q, Yu Y, Liu Y, Wang L. Outcome of varicocelectomy on different degrees of total motile sperm count: a systematic review and meta-analysis. Syst Biol Reprod Med 2019;65:430–6
Liu L, Li J, Liu G, Pan C, Bai S, et al. Nomogram for predicting spontaneous pregnancy after microscopic varicocelectomy in infertile men with normal hormone. BMC Pregnancy Child Birth 2022;22:791
Shabana W, Teleb M, Dawod T, Elsayed E, Desoky E, et al. Predictors of improvement in semen parameters after varicocelectomy for male subfertility: a prospective study. Can Urol Assoc J 2015;9:E579–82
Kiuchi H, Koga M, Hirai T, Namba Y, Takeyama M, et al. [Predictive factors associated with successful varicocele repair a study of 139 infertile men with valicocele. Nihon Hinyokika Gakkai Zasshi 2005;96:480–6. [Article in Japanese]
Ren W, Qu J, Xue B, Hu J, Zu X. Infertility duration and pre-operative sperm progressive motility are significant factors of spontaneous pregnancy after varicocele repair. Am J Reprod Immunol 2020;84:e13318
Giagulli VA, Carbone MD. Varicocele correction for infertility: which patients to treat?. Int J Androl 2011;34:236–41
Pereira R, Sá R, Barros A, Sousa M. Major regulatory mechanisms involved in sperm motility. Asian J Androl 2017;19:5–14
Krausz C, Riera-Escamilla A. Genetics of male infertility. Nat Rev Urol 2018;15:369–84
Hajder M, Hajder E, Husic A. The effects of total motile sperm count on spontaneous pregnancy rate and pregnancy after IUI treatment in couples with male factor and unexplained infertility. Med Arch 2016;70:39–43
Merviel P, Heraud MH, Grenier N, Lourdel E, Sanguinet P, et al. Predictive factors for pregnancy after intrauterine insemination (IUI): an analysis of 1038 cycles and a review of the literature. Fertil Steril 2010;93:79–88
Borges E Jr, Setti AS, Braga DP, Figueira RC, Iaconelli A Jr. Total motile sperm count has a superior predictive value over the WHO 2010 cut-off values for the outcomes of intracytoplasmic sperm injection cycles. Andrology 2016;4:880–6

Auteurs

Andrea Crafa (A)

Department of Clinical and Experimental Medicine, University of Catania, Catania 95123, Italy.

Marco Russo (M)

Department of Physics and Astronomy, University of Catania, Catania 95123, Italy.
INFN-Section of Catania, Catania 95123, Italy.

Rossella Cannarella (R)

Department of Clinical and Experimental Medicine, University of Catania, Catania 95123, Italy.
Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic Foundation, Cleveland, OH 44195, USA.

Murat Gül (M)

Department of Urology, Selcuk University School of Medicine, Konya 42750, Türkiye.

Michele Compagnone (M)

Department of Clinical and Experimental Medicine, University of Catania, Catania 95123, Italy.

Laura M Mongioì (LM)

Department of Clinical and Experimental Medicine, University of Catania, Catania 95123, Italy.

Vittorio Cannarella (V)

Department of Clinical and Experimental Medicine, University of Catania, Catania 95123, Italy.

Rosita A Condorelli (RA)

Department of Clinical and Experimental Medicine, University of Catania, Catania 95123, Italy.

Sandro La Vignera (S)

Department of Clinical and Experimental Medicine, University of Catania, Catania 95123, Italy.

Aldo E Calogero (AE)

Department of Clinical and Experimental Medicine, University of Catania, Catania 95123, Italy.

Classifications MeSH