Could testicular Varicocele be a cause of male infertility?

Could testicular Varicocele be a cause of male infertility?

Many couples have expressed their frustration because of delayed pregnancy, and some men have asked the question “DoVaricoceles cause infertility?” Several scientific studies have come out with the conclusion that Varicoceles may be linked to fertility problems in males unable to fertilize their wives. It was often believed, in the past, that infertility was primarily due to a woman-related factor, but with the recent scientific advances in research, it became clear that the male factor constitute at least 40% with Varicocele being a prime suspect in many of these.     

Approximately 1/3 of infertile men who have never fathered a child have a Varicocele, and > 50% of men who were once fertile, but are now infertile, also have a Varicocele. This raised doubt that Varicocele could be causing a progressive time-dependent deterioration in fertility.    

So what is a Varicocele?

Varicocele is the abnormal dilation and expansion of certain veins within the scrotum (= the veins of the testicles), which leads to the reflux of venous blood and reversal of its flow within the same veins that were supposed to propel the blood upwards towards the heart.

This induces pooling of venous blood inside the scrotum and a rise in testicular temperature. Even a one degree rise in testicular temperature can have a negative impact on sperm production.

How can Varicocele impact fertility?

Low Sperm Count: Varicoceles are highly suspected to be a cause for low sperm count because of the environment that is created, which is too warm for male reproductive organs to function well.

Lower Testosterone Hormone Level: Varicoceles have been linked to lower testosterone levels, which can affect sexual function.

DNA Damage in Sperm: Varicoceles have been attributed to DNA damage in sperm. Studies suggest that men with Varicocele have more damaged sperm than men who do not suffer from the problem.

How to know if I have one?

Varicoceles are usually progressive; starting small and growing over time. Very small Varicoceles usually don’t present symptoms other than occasionally may impact sperm quality. In the case that you have an abnormal semen analysis, the doctor may perform an ultrasound of the scrotum to look for small Varicoceles or inflammation of the epididymis.

As the Varicocele grows over time it can be identified by examining the testicle. Your urology doctor in dubai will feel for an enlarged bundle of veins above the testicles.

Men may experience other symptoms associated with the Varicocele, the most common of which is pain! A Varicocele can cause the testicles to hang lower than usual, feel heavy (particularly after long periods of standing) and even cause a dull kind of pain. If you are experiencing any of these symptoms and are thinking about having children, it is a good idea to go in and get checked out.

Is it treatable?

It’s natural for men to worry about treatment options, but the good news is that Varicocele can be effectively treated, with loads of published reports demonstrating the benefit of Varicocele surgery to improve sperm counts.

The advance in surgical technology is revolutionary, and nowadays the use of minimally-invasive techniques is considered one of the most successful surgical solutions for treating Varicocele. Through a very small incision (only 2 – 3 cm), the abnormally-dilated veins are identified and ligated. This procedure usually takes no more than 45 minutes, and the patient does not need more than a few hours in the hospital and then allowed to return home on the same day. Among the advantages of this procedure are the less post-operative pain and the speedy recovery with ability to return to light daily routine within a few days.

To sum it up, Varicocele repair can be a cost-effective solution for male infertility. Men may upgrade to normal semen, thus allowing for a natural pregnancy, or upgrade to semen of sufficient quality for artificial reproduction (e.g. IVF). 

When it comes to Varicocele and male infertility, a mixture of proper diagnosis, personalized plan of treatment, and surgical expertise  could be highly successful in helping a man restore his fertility and go on to father children.

Dr. Anis Haddad

Urologist, Sexologist & Male Health Expert.