{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T05:34:27Z","timestamp":1785908067669,"version":"3.56.0"},"reference-count":31,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,5,30]],"date-time":"2025-05-30T00:00:00Z","timestamp":1748563200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,5,30]],"date-time":"2025-05-30T00:00:00Z","timestamp":1748563200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Andrology"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Varicocoele 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To 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\u2010operative improvements in semen parameters following microsurgical subinguinal varicocelectomy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>A 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 \u22655 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\u2010microsurgical subinguinal varicocelectomy. Statistical analyses included chi\u2010square tests and logistic regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Microsurgical subinguinal varicocelectomy patients demonstrated significant improvements in sperm concentration (35.2\u201343.3\u00a0\u00d7\u00a010\u2076\/mL), motility (26%\u201338%), and total motile sperm count (18.8\u201334.9\u00a0\u00d7\u00a010\u2076,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001). 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%,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.05). Multivariate analysis revealed that microsurgical subinguinal varicocelectomy significantly increased pregnancy (OR\u00a0=\u00a01.43, 95% CI: 1.12\u20131.83,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.05) and live birth rates (OR\u00a0=\u00a01.56, 95% CI: 1.21\u20132.02,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion and conclusion<\/jats:title>\n                    <jats:p>Microsurgical 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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/andr.70070","type":"journal-article","created":{"date-parts":[[2025,5,30]],"date-time":"2025-05-30T05:25:56Z","timestamp":1748582756000},"page":"487-495","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Comparative efficacy of varicocelectomy and intrauterine insemination in varicocoele patients with mild semen abnormalities: An observational study"],"prefix":"10.1111","volume":"14","author":[{"given":"Yanlin","family":"Ma","sequence":"first","affiliation":[{"name":"Department of Reproductive Medicine The First Affiliated Hospital of Hainan Medical University  Haikou China"},{"name":"Hainan Provincial Key Laboratory for Human Reproductive Medicine and Genetic Research &amp; Key Laboratory of Reproductive Health Diseases Research and Translation, Ministry of Education &amp; Hainan Provincial Clinical Research Center for Thalassemia The First Affiliated Hospital of Hainan Medical University, Hainan Medical University  Haikou Hainan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weiming","family":"Deng","sequence":"additional","affiliation":[{"name":"Department of Urology The First Affiliated Hospital of University of South China  Hengyang Hunan Province China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tingting","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Reproductive Medicine The First Affiliated Hospital of Hainan Medical University  Haikou China"},{"name":"Hainan Provincial Key Laboratory for Human Reproductive Medicine and Genetic Research &amp; Key Laboratory of Reproductive Health Diseases Research and Translation, Ministry of Education &amp; Hainan Provincial Clinical Research Center for Thalassemia The First Affiliated Hospital of Hainan Medical University, Hainan Medical University  Haikou Hainan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qi","family":"Li","sequence":"additional","affiliation":[{"name":"Hainan Modern Women and Children's Hospital Reproductive Medicine  Haikou Hainan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuanjie","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Urology Honghuagang District People's Hospital  Zunyi City Guizhou Province China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenjie","family":"Mai","sequence":"additional","affiliation":[{"name":"Department of Urology Sanya People's Hospital  Sanya City Hainan Province China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lizheng","family":"Yan","sequence":"additional","affiliation":[{"name":"Department of Reproductive Medicine The First Affiliated Hospital of Hainan Medical University  Haikou China"},{"name":"Hainan Provincial Key Laboratory for Human Reproductive Medicine and Genetic Research &amp; Key Laboratory of Reproductive Health Diseases Research and Translation, Ministry of Education &amp; Hainan Provincial Clinical Research Center for Thalassemia The First Affiliated Hospital of Hainan Medical University, Hainan Medical University  Haikou Hainan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Changwei","family":"Liang","sequence":"additional","affiliation":[{"name":"Department of Urology Hainan Western Central Hospital  Danzhou City Hainan Province China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-1892-5076","authenticated-orcid":false,"given":"Lingxiao","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Reproductive Medicine The First Affiliated Hospital of Hainan Medical University  Haikou China"},{"name":"Hainan Provincial Key Laboratory for Human Reproductive Medicine and Genetic Research &amp; Key Laboratory of Reproductive Health Diseases Research and Translation, Ministry of Education &amp; 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