الفهرس 
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Abstract
Infertility affects around 15% of couples worldwide. It is characterized as the inability to conceive after a year of continuous sexual activity without protection. Male fertility can be impacted by genitourinary infections, immune system issues, genetic faults, gonadotoxic exposure, endocrine abnormalities, systemic illnesses, cancer, and varicoceles. In 35% of instances, varicocele is the sole reason of infertility.
Varicoceles are pathological dilations of the venous pampiniform
plexus of the spermatic cord and occur more frequently on the
left side. Varicoceles are found in 19 to 41% of infertile men and is one treatable form of male infertility. The mechanism by which varicoceles cause the variable effect on male infertility and spermatogenesis is still unknown, however, different theories were proposed to explain its role as increased intra-scrotal temperature and oxidative stress.
Glycerylphosphocholine (GPC), an important constituent of human seminal plasma. It is present in high concentrations in the epididymis of male humans, and it has been suggested that metabolic and physical activities of spermatozoa (e.g. respiration and motility) are significantly affected by GPC. Therefore, measurement of GPC is potentially important in determining male fertility. In addition, the exact effect of varicocele on levels of seminal GPC is yet to be investigated.
The current study aimed was to assess seminal alpha-GPC in infertile men post varicocelectomy. This Case-control study was done on 40 men at Beni-Suef University hospital’s and Al Kasr El-Ainy hospital’s Andrology, Sexology, and STIs department.
The main results of the study revealed that:
▪ Infertile OAT men with varicocele showed statistically significant decrease regarding semen volume, sperm counts and percentage of motile sperms when compared to fertile Normozoospermic men.
▪ After varicocelectomy, semen parameters showed significant improvement compared to the pre-operative levels.
▪ Alpha GPC level and percentages of normal sperm forms was statistically significantly higher among fertile Normozoospermic men and infertile OAT men post varicocelectomy when compared to infertile OAT men with varicocele (either grade II or III).
▪ Alpha GPC and sperm normal forms showed statistically significant increase in grade III varicocele when compared to grade II among post varicocelectomy.
▪ There was statistically significant positive correlation between alpha GPC level and semen parameters including sperm normal forms, sperm Count and sperm Motility.
▪ Seminal alpha-GPC protein showed a sensitivity of (100%) and a specificity of (100%) in differentiation between infertile OAT patients with varicocele and fertile Normozoospermic men.