Varicocele and Male Infertility: Recent Advances in Diagnosis and Therapy

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In other situations, a couple may have better results with assisted fertilization techniques, such as intrauterine insemination IUI and in vitro fertilization IVF.

There is no evidence that varicoceles inevitably make a man infertile. In 10 to 20 percent of men , the varicocele comes back after surgery. Men who notice swollen veins should not assume they will have fertility issues, though they may wish to discuss the risk with a doctor.

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Article last reviewed by Tue 30 October Visit our Fertility category page for the latest news on this subject, or sign up to our newsletter to receive the latest updates on Fertility. All references are available in the References tab. Cassidy, D.

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Varicocele surgery or embolization: Which is better? Enatsu, N. Clinical outcome of microsurgical varicocelectomy in infertile men with severe oligozoospermia [Abstract]. How are varicoceles treated? Kroese, A. Surgery or embolization for varicoceles in subfertile men [Abstract]. Cochrane Database of Systematic Reviews. Nevoux, P. Current Opinion in Obstetrics and Gynecology , 23 3 , — Shafi, H.

Prevalence of varicocele among primary and secondary infertile men: Association with occupation, smoking and drinking alcohol. What are varicoceles? MLA Villines, Zawn. MediLexicon, Intl. APA Villines, Z. MNT is the registered trade mark of Healthline Media. Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a healthcare professional.

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Send securely. Message sent successfully The details of this article have been emailed on your behalf. Reviewed by Daniel Murrell, MD. Table of contents What is a varicocele? Do varicoceles cause infertility? Causes and risk factors Diagnosis Treatment Outlook. Varicoceles affect about 10 to 15 percent of men. Image credit: BruceBlaus, Signs and symptoms of infertility. A doctor may use an ultrasound to diagnose a varicocele. Amsterdam, Netherlands: Elsevier; An update on the clinical assessment of the infertile male. Molina PE. Chapter 8. Male reproductive system.

In: Molina PE, ed. Endocrine Physiology. Male reproductive physiology.

Updated February 3, Accessed January 30, Chapter Disorders of the male reproductive tract. Pathophysiology of Disease. April Common medications and drugs: how they affect male infertility. Urol Clin N Am. Male factor infertility. Endocrinol Metab Clin North Am. Optimizing natural fertility. Fertil Steril. Genetic considerations related to intracytoplasmic sperm injection ICSI. Intracytoplasmic sperm injection ICSI —what are the risks? Urol Clin North Am. Why treat the male in the era of assisted reproduction?

Semin Reprod Med. Mah PM, Webster J. Hyperprolactinemia: etiology, diagnosis, and management. Sokol RZ. Endocrinology of male infertility: evaluation and treatment. Management of male hypogonadism. Gonadorelin acetate. Clinical Pharmacology [database online]. Accessed February 24, Treatment of male infertility. Does varicocele repair improve male infertility? An evidence-based perspective from a randomized, controlled trial. Eur Urol. The management of obstructive azoospermia: AUA best practice statement.

Revised, Howards SS. N Engl J Med. Empirical medical therapy for idiopathic male infertility: a survey of the American Urological Association. J Urol.

Varicocele and Male Infertility: Recent Advances in Diagnosis and Therapy

Featured Issue Featured Supplements. Subscribe Jobs. US Pharm. Definitions and Epidemiology Infertility is defined as the inability to achieve conception despite one year of regular, unprotected intercourse. Evaluation The American Urological Association AUA recommends an initial screening evaluation of the male partner of an infertile couple if pregnancy has not occurred within one year of regular, unprotected intercourse. The drop in percent normal morphology reflects the idea that a large proportion of sperm with normal shapes were becoming less and less important for normal fertility.

The data is a based on semen parameters from 1, men from 14 different countries whose partners became pregnant within 12 months of discontinuing contraceptive use. This is divergent from prior tables from the WHO which focused on sperm parameters from fertility-challenged men. In general, a patient can find their sperm parameters on the chart and determine what percentage of fertile men had a similar parameter. The full evaluation of an infertile male includes a complete reproductive and medical history, a physical exam, and at least two semen analyses.

Based on the results of the full evaluation, other procedures and tests to elucidate the etiology of infertility may be recommended. These tests may include additional semen analyses, endocrine evaluation, post-ejaculatory urinalysis, ultrasonography, specialized tests on semen and sperm, and genetic screening. Watch for higher risk for testes cancer, including cancer in the contralateral descended testis. Disruption of the tunica albuginea may result in anti-sperm antibodies, which should be screened for on a semen analysis.

Varicocele and Male Infertility - Recent Advances in Diagnosis and Therapy | E.-W. Jecht | Springer

Post pubertal mumps orchitis, can reduce fertility. Pre-pubertal mumps do not generally impact subsequent fertility. Pre-pubertal mumps are not a problem. A history of sexually transmitted diseases can cause scaring, especially in the epididymis, which may cause post-testicular obstruction. In the case of erectile dysfunction, the man must be able to achieve penetration and antegrade ejaculation. Lubricants are toxic to sperm motility.