Varicoceles

Forty percent of men who are diagnosed with male factor infertility may have a varicocele. A man’s testicles have veins that support proper circulation of blood back up to the heart. There are valves in the veins that stop blood from flowing backwards. When the valves fail, blood pools in the veins of the testicles, creating a varicocele. These veins may bulge, causing discomfort or a heavy feeling in the scrotum. The veins are similar in appearance to spider veins seen in the legs.

The testicles are located outside of the man’s body because they need to be at a lower temperature for proper sperm production. Varicoceles cause an increase in the temperature of the testicle, which often results in lower sperm concentration and motility, and an increase in abnormal sperm shape. All of these parameters, which are observed in a routine semen analysis, contribute to a man’s infertility.

A varicocele is diagnosed by ultrasound or a Valsalva maneuver, in which the patient stands in a warm room and bears down as if having a bowel movement. As more blood is forced to the testicles, the physician is able to palpate the testicles to locate the bulging vein.

Varicoceles are treated with surgery. A urologist makes a small incision in the abdomen and locates the varicocele. The vein is then closed off, stopping its blood flow. An alternative approach is to inject alcohol or coils into the vein to stop blood flow. Both procedures are out-patient, and have a three to four day recovery period.

Results from varicocele repair vary, however studies report that 33% of men’s semen parameters improved following surgery. Approximately 30-60% of these men were able to naturally conceive within one year of their surgery. Improvements in semen parameters are visible after four months; however, if improvements are not seen within six months, additional fertility treatments may be necessary to attain a pregnancy.
Lifestyle changes also help to improve success rates before and after varicocele surgery. Eliminating smoking, recreational drugs, anabolic steroids, and alcohol improves semen parameters. Exercising and taking vitamins that have antioxidants improve sperm production as well. Lubricants should be avoided when trying to conceive.

For more information about varicoceles, ask your physician at CNY Fertility Center.