About Varicocele Infertility

• Increase in testicular temperature occurs due to irregular flow of blood in the veins that drain the testicle and in the artery entering the scrotum. If the temperature remains increased for a long time, it may have negative effects on sperm production.
• Abnormal accumulation of adrenal and renal substances may lead to impeded development of normal sperm.
• Abnormal venous blood flow results in increased metabolic waste products and reduces the accessibility of needed oxygen and nutrients for development of sperm.
• There are also chances of interfering of abnormal blood with testosterone concentration. It, in turn may interfere with sperm production.

There is a chance that some men with major varicocele may not have any proof of testicle injury, while a small varicocele in others may cause infertility. Thus, it becomes difficult to define how varicocele would affect sperm.

Usually, varicocele is diagnosed and repaired by urologists. Still, surgical procedure does not result in improved semen quality, which is required to change the mode of therapy needed by couples for conceiving. It has been found in studies that surgery of varicocele can improve sperm count or motility but it does not consistently improve pregnancy rates.

Thus, if inseminations with husband’s sperm or in vitro fertilization is needed to cure infertility, then it is recommended that a couple should not waste time and money on varicocele surgery. These treatments are decided according to the degree of abnormality in the semen and other factors which contribute to the individual case.

For instance, if the motility is below about 30 percent and the count is less than about 5 to 10 million per cc, it is almost unlikely that varicocele repair will improve the semen quality without inseminations or IVF.

Men with slightly low counts, i.e. less than 15 to 20 million are the most eligible candidates for varicocele surgery. But prior to surgery in case of varicocele infertility, the woman should also be examined, in case her tubes are blocked or if there is an ovarian reserve problem. In this instance, surgery on the man is not recommended and may not even be necessary.

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