Five Facts to Know About Varicocele and Male Infertility

Varicocele is a common clinical diagnosis in men who get to fertility clinics for fertility tests or treatments. Couples are anxious about its cause and also impact on male fertility. Despite being a common diagnosis, it is important to consider each couple on a case by case basis.

How common is Varicocele in men experiencing male infertility?

Varicocele is a common condition. Almost 15% of adult men may have been diagnosed or suspected to have a varicocele. But, it is even more common in men attending fertility clinics with their partners.

In this subgroup of patients, a varicocele may be identified in almost 40-50% of men. The majority of these men have no problems in achieving pregnancy with their partners.

How does Varicocele affect male fertility?

It is not known as to what causes varicocele and how it exactly affects male fertility. It is thought that the dilated veins lead to pooling of the blood in the sac surrounding the testes.

This results in higher than the desired temperature in the scrotal sac. The rise in local temperature can damage the sperm. It can also hurt the process involved in maturation and production of sperms.

This can result in male infertility. Men with Varicocele and male infertility may have either an average sperm count or may have low sperm count, low sperm motility (sperm movement) or low normal sperm morphology (sperm shape).

Should I consider an operation for Varicocele or IVF or ICSI?

There are various treatment options for men identified with varicocele and experiencing male infertility. You may consider an operation for varicocele rather than advanced fertility treatments.

This approach is suggested for men who have been experiencing fertility problems and have no other identified cause of infertility as a couple.

It is important to bear in mind that it takes around 3-6 months to see improvement in the sperm parameters. These are sperm count and sperm motility.

There can be other contributory factors that may be preventing your partner from getting pregnant. These can be a reduced ovarian reserve or her age.

Then you may rather proceed with advanced fertility treatments such as ICSI or IVF in preference to varicocele surgery. It is important you discuss this with your fertility specialist.

Various studies state that men undergoing an operation to correct varicocele may see improvement in their semen analysis such as sperm count or sperm motility.

But, it is still controversial whether it reflects in improvement in pregnancy or live birth rates. There is a possibility that surgery may help some couples to achieve a natural conception and avoid risks of fertility treatments.

In others, it might improve the sperm parameters, thus the outcome of fertility treatments such as Insemination or ICSI. But, there is a chance that despite surgery, a varicocele may persist or recur. For such couples, they may still have to proceed with fertility treatments such as ICSI.

Having varicocele surgery to improve fertility has to be discussed with your fertility specialist. You should have the full understanding of the risks and the benefits.

How long should we try for natural conception after an operation to correct Varicocele?

It takes around 3-6 months from the surgery to see whether there are any noticeable improvements in semen analysis. If the semen analysis returns to normal and there is no other reason to explain infertility, then you may try naturally for six months to a year. It may be reasonable to regularly do semen analysis every 3-4 months.

This will ensure that the improvements are maintained while you and your partner are trying to conceive naturally. Nonetheless, this should be discussed with your fertility specialist or gynaecologist or andrologist.

Will correction of Varicocele improve ICSI or IVF success rate?

A successful correction of the varicocele may improve the sperm parameters. It may lead to a change in your treatment options. It is still unknown whether it will result in improved ICSI or IVF success rate.

The correction of varicocele is usually not advised only to improve the fertility treatment success rates. It may be considered for fertility-related or other reasons.