Correlation of Ultrasonographic Varicocele Grading with Seminal Fluid Analysis in Male Infertility at Ahmadu Bello University Teaching Hospital, Zaria, Nigeria.

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Background: Infertility is a global health issue with profound social and psychological consequences, particularly in sub-Saharan Africa, where male factors are often underdiagnosed. Varicocele, a dilatation of the pampiniform plexus veins, is a leading correctable cause of male infertility. Seminal fluid analysis (SFA) remains the cornerstone for evaluating male fertility. Establishing correlations between ultrasound grading of varicocele and semen parameters may provide clinicians with predictive, non-invasive tools for managing infertility. The objective of the study is to correlate the ultrasound grading of varicocele with seminal fluid findings in infertile men. Methodology: This was a cross-sectional analytical study conducted on 225 infertile men aged 23-68 years with sonographically confirmed varicocele at Ahmadu Bello University Teaching Hospital, Zaria, between September 2023 and June 2024. Participants underwent scrotal ultrasonography using Sarteschi's criteria for varicocele grading, and semen analysis was performed in accordance with WHO 2010 guidelines. Data were analyzed with SPSS v23 using descriptive statistics, ANOVA, and Spearman correlation. Results: The modal age group was 31-35 years (28.4%). Left-sided varicocele was most common (44.4%), followed by right (35.5%) and bilateral (20%). Varicocele grade distribution was: I (20.4%), II (19.1%), III (24.4%), IV (14.2%), and V (21.7%). Higher varicocele grades correlated negatively with sperm count (r = -0.64, p = 0.001), motility (r = -0.40, p = 0.021), and morphology (r = -0.43, p = 0.013). Patients with grade IV-V varicocele showed significantly impaired semen quality compared to grades I-II. Conclusion: Increasing varicocele grade is associated with progressive deterioration in semen parameters. Ultrasound grading of varicocele may serve as a reliable predictor of seminal quality, assisting in clinical decision-making for the management of male infertility.

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