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The consistent elevation of pro-inflammatory cytokines (TNF-, IL-6) and oxidative stress markers in the semen and serum of varicocele patients correlates negatively with semen quality and weakly or inconsistently with IIEF-5 scores, while novel biomarkers such as miR-210, sRAGE, and extracellular vesicles (EVs) exhibit preclinical promise for the early diagnosis and prognostic evaluation of varicocele-related complications (209)