ABSTRACT
Varicoceles are a common cause of male infertility, but despite data from human studies some points of the pathophsiology remains unclear. Seminal plasma cadmium concentrations were found to be increased in infertile men. In addition, increases in blood plasma cadmium concentrations in infertile men have been associated with teratozoospermia. Cadmium contributes to infertility by induction of apoptosis in testicular tissue
Methods: An ejaculate and blood sample were collected immediately before surgery from 45 infertile men with varicocele classified into 3 groups [group 1 included 12 oligospermic, group 2 included 14 asthenospermic and group 3 included 19 oligoasthenospermic men] followed by aspiration of hydrocele fluid from the tunica vaginalis at the time of subinguinal varicocelectomy. Blood samples were collected from 10 healthy fertile men as control group. In each specimen, cadmium and iron levels were determined by atomic absorption spectrophotometer and the effect of hydrocele fluid on the sperm velocity was determined by examining aliquots of sperms suspended in hydrocele fluid compared to those suspended in seminal plasma
Results: The cadmium level was found to be significantly higher in the hydrocele fluid than peripheral blood, while the increase in the iron level was found to be non significant in the 3 patients groups with bilateral varicocele. Hydrocele fluid added to the sperms, initially increased the motility for 10 to 15 minutes then the velocity diminished gradually and eventually all the sperms became immotile in 30 minutes
Conclusions: 1- The hydrocele fluid in patients with varicocele has a deleterious effect on the sperm vitality. 2- The increased cadmium and iron concentrations in the hydrocele fluid are probably drived from the increased transvascular fluid exchange which occurs with varicocele. 3- These metal ions may diffuse from the hydrocele fluid to the sperms during their maturation in the epididymis and induce their acrosomal insufficiency effect