Volume 22, Issue 7 (July 2024)                   IJRM 2024, 22(7): 605-608 | Back to browse issues page

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Sanjari E, Raeisi Shahraki H. Comments on “Negative effect of varicocele on sperm mitochondrial dysfunction: A cross-sectional. IJRM 2024; 22 (7) :605-608
URL: http://ijrm.ir/article-1-3146-en.html
Comments on “Negative effect of varicocele on sperm mitochondrial dysfunction: A cross-sectional
Elaheh Sanjari1 , Hadi Raeisi Shahraki *2
1- Student Research Committee, Shahrekord University of Medical Sciences, Shahrekord, Iran.
2- Department of Epidemiology and Biostatistics, Faculty of Health, Shahrekord University of Medical Sciences, Shahrekord, Iran. , raeisi.shahraki_hadi@yahoo.com
Keywords: 1. Elahi M, Hojati V, Hashemitabar M, Afrough M, Kargar HM, Dastoorpoor M. Negative effect of varicocele on sperm mitochondrial dysfunction: A cross-sectional study. Int J Reprod BioMed 2023, 21: 323-332. 2. Savitz DA, Wellenius GA. Can cross-sectional s
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Dear Editor
Recently, Elahi et al., published an article entitled above and concluded that the varicocele negatively affects sperm concentration, motility, morphology, sperm DNA fragmentation index, mitochondrial membrane potential level, and adenosine triphosphate (1). However, we believe that the conclusion is doubtful due to the following reasons:
  1. Talking about any causality effect in the cross-sectional studies is forbidden, because exposure and outcome are assessed at the same time and may be susceptible to reverse causality (2).
  2. There is no confounder adjustment in the results section. For example, the paternal age is one of the most important confounders. Findings of a meta-analysis showed a 3-22% decrease in semen volume and 3-37% in sperm motility among men over 50 yr (3), but we did not find any age adjustment.
  3. Statistically significant does not reflect any information about the effect of varicocele.
  4. It lacks any statistical analysis to show the prediction power, discrimination power, or variable importance. The performed statistical analysis (Mann-Whitney U test and Spearman correlation) does not infer the effect of varicocele on sperm mitochondrial dysfunction.
Apart from the points discussed in this note, which we hope will be useful to the researchers, we would like to thank Elahi et al., for sharing their valuable article and in-depth investigation and analysis with us. In conclusion, the interpretations of findings must be regarded with caution.

Conflict of Interest
Nothing to declare.
Type of Study: Letter to Editor | Subject: Reproductive Epidemiology
References
1. Elahi M, Hojati V, Hashemitabar M, Afrough M, Kargar HM, Dastoorpoor M. Negative effect of varicocele on sperm mitochondrial dysfunction: A cross-sectional study. Iran J Reprod BioMed 2023 May;21(4):323. [DOI:10.18502/ijrm.v21i4.13271] [PMID] [PMCID]
2. Savitz DA, Wellenius GA. Can cross-sectional studies contribute to causal inference? It Depends. American Journal of Epidemiology. 2023 Apr;192(4):514-6. [DOI:10.1093/aje/kwac037] [PMID]
3. Kidd SA, Eskenazi B, Wyrobek AJ. Effects of male age on semen quality and fertility: a review of the literature. Fertility and sterility. 2001 Feb 1;75(2):237-48. [DOI:10.1016/S0015-0282(00)01679-4] [PMID]
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