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Objective To evaluate the current literature on the impact and potential mechanisms of varicocele repair on male fertility. Design Pertinent articles were identified through computer PubMed search on varicocele repair and male factor infertility. References of selected articles were hand searched for additional citations. Conclusion(s) Varicocele repair has been shown to reverse a spectrum of effects contributing to men with impaired fertility. Clinical studies on the intervention have illustrated variable effects on postoperative sperm parameters and pregnancy rates (PR). Studies with conflicting results suffer from a significant number of confounding variables such as variable repair technique or lack of controls. Additional studies are warranted on the role of modern microsurgical varicocelectomy given the improvements in assisted reproductive technologies (ART).

Agonist (N1⁄4510) Antagonist (N1⁄42195) p DESIGN: Open controlled parallel study, including 256 women. Study period: January 2011 January 2013. Inclusion criteria: age

Objective: To assess the association between pelvic pain and uterine remnants and review the management of pelvic pain in females with Mayer-Rokitansky-K€ uster-Hauser (MRKH) syndrome. Design: Retrospective cohort. Setting: Department of Obstetrics and Gynecology at a tertiary referring medical center. Patients: Forty-eight females with MRKH presenting from 1997 to 2011 with anatomy confirmed by magnetic resonance imaging (MRI). Interventions: None. Main Outcome Measure: Prevalence Of uterine remnants and the association of uterine remnants with pelvic pain in females with MRKH. Results: Of the 48 females with MRKH, 23 (48%) had uterine remnants and 22 (46%) had pelvic pain. Presence of endometrium was associated with pelvic pain (RR 5 2.3; 95% CI 5 1.2-4.7) in females with MRKH. Of the females with MKRH and pain, 9/22 had laparoscopy, with endometriosis seen in 5/9 of the uterine remnants at stages higher than are usually seen in teenagers (56%). Nine patients with pain and uterine remnants (8 with endometrium, 1 without) had laparoscopic removal of uterine remnants with resolution of pain. Conclusions: Given the high prevalence of uterine remnants in females with MRKH, anatomic evaluation with MRI should be considered when assessing the etiology of pelvic pain. Presence of endometrium within uterine remnants, and subsequent endometriosis, in females with MRKH may be associated with pelvic pain necessitating surgical or medical management.