• Samet Verim, Sami Uguz, Serhat Celikkanat, Ali Guragac, Turker Turker, Bahadir Topuz, Ramazan Demirci, Bilal Firat Alp, Hasan Cem Irkilata, and Mutlu Sağlam.
• Department of Radiology, Mevki Military Hospital, Ankara, Turkey drsametverim@yahoo.com.
• J Ultrasound Med. 2016 Jun 1; 35 (6): 1241-50.

ObjectivesThe purpose of this study was to determine prognostic factors affecting semen parameters in patients with varicocele during the postadolescent period.MethodsThis study was approved by the Institutional Review Board. Between May 2013 and May 2015, we prospectively obtained demographic and sonographic data from postadolescent patients with varicocele. Potential risk factors affecting semen parameters, including age at diagnosis, height, weight, body mass index, varicocele laterality, varicocele grade, left testicular volume, right testicular volume, total testicular volume, testicular atrophy index, testicular volume differential, right and left maximum vein diameters, peak retrograde flow velocity, reflux flow volume, and reflux grade in both supine and standing positions, were recorded.ResultsThe left peak retrograde flow velocity, reflux flow volume, and reflux grade in the supine and standing positions, left testicular volume, right testicular volume, total testicular volume, and follicle-stimulating hormone level were found to be associated with abnormal semen parameters (P < .05). By multivariate analysis, the follicle-stimulating hormone level was associated with the sperm concentration and morphologic characteristics, and the left peak retrograde flow velocity in the standing position was associated with deterioration of sperm motility and morphologic characteristics. Additionally, the left reflux grade in the standing position was associated with the sperm concentration, and the left testis volume was associated with motility.ConclusionsThe left peak retrograde flow velocity and reflux grade in the standing position were significantly associated with all semen analysis parameters. This finding supports the use of testicular duplex Doppler sonography as a noninvasive tool for evaluation of testicular function in patients with varicocele and helps clinicians determine patients' fertility status.© 2016 by the American Institute of Ultrasound in Medicine.

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