Varicoceles and Male Infertility

It is a varicose (enlarged) vein in a man’s scrotum, which can cause infertility by reducing sperm production and quality. Structurally, a varicocele resembles a varicose vein in the leg.

Varicoceles (also called testicular varicoceles) are common in the male population, with about 15% of men experiencing one. And they most often occur on the left testicle. The majority of men with a varicocele remain fertile.

According to the American Society for Reproductive Medicine (ASRM), varicoceles are present in 40% of men diagnosed with infertility. The infertility awareness organization RESOLVE notes that the incidence of varicoceles increases in men who have once fathered a child but are infertile when trying for another child (50%-80%). This is evidence that varicoceles have a progressive effect on male infertility related to increasing age.

These factors cause fertility specialists to consider them to be a prime concern in finding the cause of infertility in men and in couples in certain circumstances.

Since fertility treatment often involves both partners, we encourage the female partner to be evaluated by us while the male partner is undergoing treatment by a male infertility specialists at another practice. Options for men with varicoceles include repair of the issue or the use of either intrauterine insemination (IUI) or in vitro fertilization (IVF) with intracytoplasmic sperm injection (ICSI). Varicocele repair can improve sperm production and male fertility on an ongoing basis, where the other treatments would be needed for each attempt at pregnancy.

Various factors go into making such a decision, which we and the male fertility specialists treating the male thoroughly discuss with the patient. These include age, the female partner’s fertility potential, the assessment of the varicocele itself and weighing the cost factors of repair versus work-around treatments.