Varicoceles and infertility

Varicoceles and infertility

Varicoceles are present in 10–20% of adult men and in over 25% of men with abnormal semen analysis. The exact associa tion between reduced male fertility and varicocele is unknown. The most accepted theory is that increased blood flow leads to higher intratesticular temperatures, which are the main cause of impaired sperm in v aricoceles. Large varicoceles may eventually cause testicular failure, ultimately resulting possibly in lower testosterone production, low sperm count and quality and testicular atrophy . Varico celes can also decrease sper m nuclear DNA integrity , which has been linked to poor sperm motility , viability , counts and morphology . A Cochrane review from 2012 concluded that there is some evidence to suggest that treatment of a varicocele in men from couples with otherwise unexplained subfertility may improve a couple’s chance of spontaneous pregnancies . However, var icocele repair in men with a subclinical varicocele or normal semen parameters is considered ine ff ective for increasing the chances of spontaneous pregnancies. Varicocelectomy may also improve outcomes following assisted r eproductive tech niques in men with abnormal sperm parameters.