Read below to learn more about Varicocele and how it is related to male infertility
What is a varicocele?
Many people have seen commercials about varicose veins, or may know about them, but are less familiar with varicocele. However, you may be surprised to learn that approximately 10-15% of men actually have varicocele.
So, what is a varicocele? A varicocele is similar to a varicose vein; however, a varicocele is an enlargement of the veins in the scrotum (sac of skin that holds the testicles)— the veins are called pampiniform plexus. When the pampiniform plexus become enlarge they are varicoceles.
The pampiniform plexus is responsible for draining blood from the testicles. They also act as a countercurrent heat exchanger, which is a contributing factor to keeping the testicles cooler than the body. They do this by cooling blood in the testicular artery before it enters the testicles.
How does varicocele relate to male fertility?
Varicocele is heavily debated in the male fertility field.
A varicocele can lead to low sperm count and quality and is a common cause of male infertility. However, it’s important to note that most who have varicoceles do not have fertility problems, even though its prevalence within male fertility cases is notable. In a study of 816 men with infertility issues, almost 1/3 had a varicocele.
When those who are looking to father a child are experience impaired fertility, varicocele might be discovered as part of a fertility evaluation.
In addition to male infertility and fertility, are there other problems associated with varicocele?
In addition to impaired fertility, varicoceles can also cause other things decreased testosterone production and discomfort of the scrotum.
Do you think you have a varicocele?
If you suspect that you may have a varicocele, it’s important to speak with your healthcare or medical provider.
They may perform a physical examination and advise on the next steps depending on what they discover. A physical exam may prove inconclusive, and your doctor may order a scrotal ultrasound to ensure there isn’t another reason for your symptoms.
Is there treatment for Varicocele?
In a number of cases, Varicocele treatment may not be necessary. However, there are scenarios where one may undergo treatment. Treatment of varicocele is done through repair methods, including open surgery, laparoscopic surgery, or percutaneous embolization.
It’s always important to discuss the next steps with your medical provider, who will make specific recommendations based on your case.
How does treatment impact male fertility?
The topic of treating varicocele may come up around fertility, especially for those that are actively trying to conceive children.
There is much debate on whether or not the treatment of varicocele leads to increased fertility. A 2012 meta-analysis looking at the surgery or embolization for varicoceles in subfertile men in previous studies found some evidence that treatment might improve fertility. However, it's important to note that more research is needed and the researchers cautioned that the existing evidence is weak.
A different literature review that was completed in 2012 concluded that "varicocele repair has been shown to reverse a spectrum of effects contributing to men with impaired fertility" and that "Clinical studies on the intervention have illustrated variable effects on postoperative sperm parameters and pregnancy." Again, more evidence and research are warranted.
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