ABSTRACT
Traditional thinking suggested that a male's role in reproduction ended upon fertilization, after which maternal factors predominate and carry an embryo until birth. As such, evaluation of the couple with recurrent pregnancy loss has focused on the female, with the American Society for Reproductive Medicine recommending a thorough history, physical exam, laboratory evaluation, and imaging. The study design is important as they were able to capture any early pregnancy loss because enrollment was performed pre-conception. Chromosomal anomalies in pregnancy loss can arise in two major ways—either random errors in germ cell proliferation or nonrandom chromosomal anomalies. The intervention group had a higher pregnancy rate, a higher live birth rate per pregnancy rate, and a lower miscarriage rate. The mechanism by which varicocele repair improved outcomes is likely related to improved sperm DNA quality, as multiple studies have demonstrated that varicocele repair improves sperm DNA and decreases reactive oxygen species.
