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Hum. Reprod. Advance Access originally published online on January 29, 2004
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Human Reproduction, Vol. 19, No. 3, 616-627, March 2004
© 2004 European Society of Human Reproduction and Embryology

Bilateral increased apoptosis and bilateral accumulation of cadmium in infertile men with left varicocele

Susan H. Benoff1,2,6, Colleen Millan1, Ian R. Hurley1, Barbara Napolitano3,4 and Joel L. Marmar5

1 Fertility Research Laboratories and 3 Biostatistics Unit, North Shore-Long Island Jewish Research Institute, Manhasset, New York, 2 Departments of Obstetrics and Gynecology and Cell Biology, New York University School of Medicine, New York, New York, 4 Department of Public Health, Cornell University Medical College, New York, New York and 5 Division of Urology, Robert Wood Johnson School of Medicine, Camden, New Jersey, USA

6 To whom correspondence should be addressed at: Fertility Research Laboratories, North Shore-Long Island Jewish Research Institute, 350 Community Drive, Room 125, Manhasset, NY 11030, USA. e-mail: sbenoff{at}nshs.edu

BACKGROUND: Varicoceles are associated with venous flux that may cause increased heat and interstitial pressure within the testes, but these effects are variable. Some men with varicocele have infertility, but others do not. We question whether other factors contribute to the infertility, and whether these other factors could be identified by specific molecular/genetic markers. Can such markers predict the outcome of varicocele repair? Can these markers be demonstrated bilaterally in unilateral left varicocele? METHODS: Limited bilateral testes biopsies were obtained by ultrasonically guided percutaneous aspiration at the time of varicocelectomy. In each specimen, cadmium levels were determined by atomic absorption and the percentage apoptosis within the seminiferous tubules was quantified. RESULTS: The percentage of apoptotic nuclei and cadmium levels were high in some men with varicocele. There was a concordance of these values in both testes despite the presence of left-sided varicocele only. These values were inversely related to an increase in sperm concentration after varicocelectomy. CONCLUSIONS: Cadmium, a metal ion inducer of apoptosis, may contribute to this form of male infertility. Apoptosis may deplete the sperm concentration among men with varicocele and infertility. Pre-operative measurements of apoptosis and cadmium content may predict the outcome of varicocele repair.

Key words: apoptosis/cadmium/varicocele/varicocelectomy


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