Varicocele is one of the main causes of male infertility. Microsurgical varicocelectomy leads to improved sperm parameters and increased fertility, however, 80% of patients with varicocele are not infertile, and spontaneous pregnancy occurs only in 36.4-65% of cases after varicocelectomy. This fact leads to the need for careful selection of infertile men with varicocele for surgical treatment. The literature review is devoted to the possibilities of proteomic analysis of sperm in men. Modern "omics" methods, in particular proteomics, are quite promising in the diagnosis of male infertility. Considering the important role of seminal plasma in the natural process of fertilization, much attention is paid to the study of its proteins. The few published studies showed that changes in seminal plasma proteins of patients with varicocele are observed not only in case of pathospermia, but also with normozoospermia, which may indicate a greater sensitivity of proteomic analysis in determining the effect of varicocele on spermatogenesis and sperm function compared to a standard sperm analysis. Since varicocele is a complex disease with various pathogenetic mechanisms that can cause infertility, the paradigm-shifting approach using post-genomic technologies may provide a more thorough understanding of the effector pathways, as well as predicting of treatment outcomes.

Keywords: seminal plasma proteomics, microsurgical varicocelectomy, male infertility, varicocele