{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T04:51:59Z","timestamp":1791435119442,"version":"4.3.3"},"reference-count":30,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T00:00:00Z","timestamp":1774828800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T00:00:00Z","timestamp":1774828800000},"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":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Varicocelectomy has been shown to improve semen parameters in men with infertility; however, not all men experience improvement. Identifying preoperative predictors of semen parameter improvement is necessary for counseling and treatment planning.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To determine if preoperative total testicular volume is associated with improved total motile sperm count (TMSC) after microsurgical varicocelectomy and to establish an optimal volume threshold for predicting clinical outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>\n                      We retrospectively reviewed 110 men who underwent microsurgical varicocelectomy for infertility between January 2017 and May 2024. Inclusion criteria were adult men with preoperative TMSC &lt;15 million and a history of at least 12 months of infertility. Testicular volume was assessed clinically by physical examination. The primary outcome was the upgrade in TMSC category after surgery, defined as a change from azoospermia, in vitro fertilization (IVF), or intrauterine insemination (IUI) to a higher category. Statistical analyses included Wilcoxon signed\u2010rank,\n                      <jats:italic>t<\/jats:italic>\n                      \u2010tests, chi\u2010squared tests, multivariable logistic regression, and receiver operating characteristic (ROC) curve analysis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of the 110 men, 56 (51%) demonstrated improvements in TMSC category. Men who experienced improvement had higher preoperative total testicular volume (33.0\u00a0mL vs. 23.4\u00a0mL,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001). ROC curve analysis identified a total testicular volume threshold of \u226525.5\u00a0mL, which was associated with a 12\u2010fold increased odds of improvement (OR 12.0, 95% CI: 2.6\u201377.5,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.003). In multivariable analysis, age, BMI, procedure laterality, varicocele grade, and preoperative FSH and total testosterone levels were not independently associated with postoperative improvement in TMSC.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion and Conclusions<\/jats:title>\n                    <jats:p>Preoperative total testicular volume is a strong predictor of improvement in TMSC following microsurgical varicocelectomy. These findings support the use of testicular volume in preoperative evaluation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/andr.70210","type":"journal-article","created":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T02:16:02Z","timestamp":1774923362000},"page":"1600-1606","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Preoperative Total Testicular Volume as a Predictor of Total Motile Sperm Count Improvement Following Microsurgical Varicocelectomy"],"prefix":"10.1111","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2238-6752","authenticated-orcid":false,"given":"Manish","family":"Kuchakulla","sequence":"first","affiliation":[{"name":"Department of Urology New York\u2010Presbyterian Hospital  New York New York USA"},{"name":"Department of Urology Weill Cornell Medical Center  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aaron A.","family":"Gurayah","sequence":"additional","affiliation":[{"name":"Department of Urology New York\u2010Presbyterian Hospital  New York New York USA"},{"name":"Department of Urology Weill Cornell Medical Center  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Phillip J.","family":"Poppas","sequence":"additional","affiliation":[{"name":"Macon &amp; Joan Brock Virginia Health Sciences Eastern Virginia Medical School at Old Dominion University  Norfolk Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hriday P.","family":"Bhambhvani","sequence":"additional","affiliation":[{"name":"Department of Urology New York\u2010Presbyterian Hospital  New York New York USA"},{"name":"Department of Urology Weill Cornell Medical Center  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John M.","family":"Masterson","sequence":"additional","affiliation":[{"name":"Department of Urology Weill Cornell Medical Center  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc","family":"Goldstein","sequence":"additional","affiliation":[{"name":"Department of Urology Weill Cornell Medical Center  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James A.","family":"Kashanian","sequence":"additional","affiliation":[{"name":"Department of Urology Weill Cornell Medical Center  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,3,30]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)32667-2"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40618-018-0952-7"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2016.06.044"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5347(01)64567-1"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.semcdb.2021.04.005"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2013.08.083"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000002786"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.urology.2007.04.011"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2011.09.041"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.4103\/aja2021125"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2014.03.046"},{"key":"e_1_2_10_13_1","article-title":"Predictors of Semen Parameters Decline Following the Microsurgical Varicocelectomy","volume":"15","author":"Greenberg D. 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