Predictive success factors in varicocelectomy using artificial intelligence.
Male infertility. Varicocele. Artificial intelligence.
Introduction. Marital infertility affects about 18% of couples of reproductive age worldwide. Around 30% to 45% the causative factor of this infertility is the male factor, with varicocele being the most common cause in these infertile men, and about 80% in cases of secondary infertility (LIRA NETO; CASTLING; ESTEVES, 2021). Varicocele is defined as venous vascular disease caused by dilation of the pampiniform venous plexus, responsible for gonadal venous drainage (LI et al., 2020). Surgical treatment for correction of varicocele is considered the gold standard to correct this pathology, however, its success rate ranges from 30% to 80% with improvement of patterns in testicular and spermatogenic function. However, these rates do not apply to pregnancy rates, which are lower. Artificial intelligence has been increasingly used to predict outcomes, including in urology, with better results than professional models (ORY et al., 2022). Goal. To identify predictors of success in varicocelectomy using artificial intelligence. Methodology. This is an experimental observational study conducted at the Faculty of Medicine of the Federal University of Alagoas. The study included patients with a clinical diagnosis of varicocele, confirmed by ultrasonography, who underwent varicocelectomy. Preoperative data such as hormonal levels of FSH, LH, testosterone, seminal parameters and aspects of health habits and pathological antecedents were listed. The seminal parameters were evaluated after the surgical procedure. We used an artificial intelligence computational tool to list the preoperative variables that predict success after varicocelectomy. In the postoperative period, we had an average improvement of 20 million in sperm concentration per milliliter of semen. Other more relevant improvement parameters were total sperm count, percentage of live espmermatozoa and percentage of motile sperm. We used the data mining tool to list by artificial intelligence algorithm which predictors of success in varicocelectomy. Conclusion. We conclude that it is possible to determine the predictors of success in varicocelectomy through artificial intelligence.