Fertility Answers - Helping Build Families

Varicocele

A varicocele is a common male fertility problem

A varicocele occurs when there is an enlargement of the veins within the scrotum that contains the testicles. This condition can occur in men due to poor functioning of valves within the veins in the scrotum that causes blood to backup and create swelling. Varicoceles are similar to varicose veins you might see in your leg. Varicoceles can cause infertility, but it’s important to note that most men with varicoceles do not have fertility issues.

Varicoceles are thought to be associated with infertility by contributing to low sperm production and decreased sperm quality. When normal blood flow doesn’t occur, the blood backs up, causing the veins in the scrotum to enlarge. The poor circulation caused by the varicocele results in a higher blood temperature, raising the temperature of the testes, which can serve as a barrier to sperm production and damage or destroy sperm that is created.

Varicoceles occur in approximately 15 percent of all men. In about 85 percent of cases, it occurs in the left testicle area. Some men experience a dull achy pain from this condition while other men have no physical symptoms at all. The dilated veins in the scrotum can often be felt or seen, and the testicle is smaller on the varicocele side.

Varicoceles can be treated with surgery

Treatment is generally necessary only for infertility, or if the varicocele is of significant size and causes persistent pain or discomfort. Non-surgical approaches to treating a varicocele include anti-inflammatory medications and wearing snug underwear or a jock strap.

Surgical repair of varicoceles in a male fertility patient should only be considered in certain cases. If a man is experiencing infertility or pain with a varicocele, he should talk to an experienced urologist, a specialist in the male reproductive system, to discuss if surgery is necessary. Surgical treatment of the varicocele usually involves tying off the affected vein to redirect the blood flow toward normal veins.

It may take three to six months after a varicocele surgical repair to see maximum results on sperm testing. It should be noted that though most studies show an improvement in sperm parameters (count, motility, morphology) after a varicocele repair, some studies do not show a significant improvement.

There are other options to treat infertility caused by varicoceles

However, surgery is not the only option for a man with fertility issues and a varicocele. It may be more beneficial to focus on fertility treatments at our Louisiana fertility center such as intrauterine insemination (IUI) or in vitro fertilization (IVF), especially if the female partner also has fertility issues of her own or is of advanced maternal age.

Additionally, given the time it takes for surgical repair and for sperm parameters to be normal again, if a couple wishes to fast track their fertility treatment, then IUI or IVF may be better alternatives. The exact success rates of IUI and IVF will depend on other fertility factors, especially the woman’s age.

If you have been diagnosed with a varicocele and suffer from infertility, speak with the team at our Louisiana fertility center to get the best advice for your specific case. Contact us to schedule an appointment.