Clinical Outcomes of Varicocele Repair in Infertile Men: A Review
Varicoceles are a major cause of impaired spermatogenesis and the most common correctable cause of male infertility. They are found in approximately 40% of men with primary infertility and 80% of men with secondary infertility, although they also occur in 12% of men with normal semen parameters. T...
| Main Authors: | , |
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| Format: | Article |
| Language: | English |
| Published: |
Korean Society for Sexual Medicine and Andrology
2016-08-01
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| Series: | The World Journal of Men's Health |
| Subjects: | |
| Online Access: | https://www.wjmh.org/Synapse/Data/PDFData/2074WJMH/wjmh-34-101.pdf |
| Summary: | Varicoceles are a major cause of impaired spermatogenesis and the most common correctable cause of male infertility. They are
found in approximately 40% of men with primary infertility and 80% of men with secondary infertility, although they also occur
in 12% of men with normal semen parameters. The presence of a varicocele does not always affect spermatogenesis, as it has
been reported that only 20% of men with documented varicoceles suffer fertility problems. However, varicocele repair appears
to have beneficial effects in men with impaired semen parameters and palpable varicoceles. Currently, the main procedures
employed for varicocele repair are microsurgical subinguinal or inguinal varicocelectomy, laparoscopic varicocelectomy, and
radiological percutaneous embolization. Microsurgical varicocelectomy appears to be the optimal treatment in most cases,
whereas the other procedures are useful only in specific cases. After treatment, it typically takes 3 to 6 months for patients’ semen
parameters to improve; thus, other therapies, including assisted reproductive technology, should be considered if infertility
persists after this interval, especially in older couples. Controversies still remain regarding how varicoceles in certain subgroups,
such as adolescents or men with azoospermia, should be treated. Due to their relatively high prevalence rate among the general
population, varicoceles can occur concomitantly with other conditions that cause impaired spermatogenesis. Further studies are
necessary in order to identify the patients who are most likely to benefit from treatment. In this review, we sought to summarize
the issues currently associated with varicocele treatment in infertile men. |
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| ISSN: | 2287-4208 2287-4690 |