Varicocele

Varicocele and male infertility

Varicoceles are abnormally dilated, or enlarged, varicose veins within a man’s scrotum. While this common condition occurs in nearly 15% of men, about 40% of men with diagnosed infertility have a varicocele. Although varicoceles are the most common diagnosis in male infertility, not all men with a varicocele are infertile.

To determine if you have a varicocele that could affect your fertility, you need a male fertility exam that includes semen analysis, blood work and a physical examination. Upon examination of your testicles, a varicocele will feel like a “bag of worms” when you’re standing up, but can’t be felt as easily when you’re lying down. In up to 93% of cases, varicoceles are found on the left side. For some men, a varicocele can also cause pain or discomfort. If your varicoceles can be felt by hand, they are more likely to be associated with male factor infertility.

With dual training in both female and male infertility, our New York male fertility specialist, Joel Batzofin, M.D., is uniquely qualified to diagnose a varicocele in men through an in-office male fertility exam, eliminating the need to see a separate specialist.

How does a varicocele affect male fertility?

While research is inconclusive, scientists believe that varicoceles may have a negative effect on sperm generation because they impede blood flow to the testicles, allow blood to reflux and cause the testicles to overheat.

Varicoceles can contribute to:

  • Low sperm count and concentration
  • Poor motility
  • Poor morphology

Varicoceles can be repaired with surgery or percutaneous embolization of the vein, but research has not yet found definitive proof that varicocele repair consistently improves fertility.

For many men, repair may improve sperm parameters. According to a meta-analysis of the limited studies available, sperm concentration increases by about 12 million sperm per mL of seminal fluid and motility improves by 11%. However, it takes three to six months to see improvement in sperm parameters after varicocele repair, and for many couples, there is still not enough improvement to achieve pregnancy without medical intervention.

For this reason, intrauterine insemination (IUI) or in vitro fertilization (IVF) are often recommended instead of varicocele repair, especially when the female partner has fertility issues as well.

You have options

If you are diagnosed with a varicocele, your treatment plan will be customized to your specific situation. Dr. Batzofin will explain your options, taking into account the severity of your varicocele, the results of your semen analysis and blood work, your and your partner’s age, the female partner’s fertility, and how quickly you’d like to have a baby.

To learn more about varicoceles and fertility treatment, contact us to schedule an appointment with our top New York male fertility specialist.