Varicocele: Impact on Fertility and Treatment Options

Varicocele

Hello Dr.
Hsu: I underwent a semen analysis due to varicocele.
The sperm count was 70 million, but the motility was poor at only 46%.
I would like to ask Dr.
Hsu: 1.
Will poor motility affect fertility? 2.
Will surgery improve this condition? 3.
I occasionally experience pain on the left side.
Is surgery necessary?

Mu Tou, 30~39 year old female. Ask Date: 2006/09/05

Dr. Xu Weikai reply Urology

The fertility potential of semen depends on both quantity and quality, with quality encompassing factors such as motility and morphology.
If the issue is caused by varicocele, surgical intervention tends to yield very good results, typically showing significant improvement around six months post-surgery.
However, if there are other factors contributing to poor semen quality, the outcomes after surgery may be more limited.
Surgery for varicocele is absolutely necessary in the following situations: 1.
When it significantly affects semen quality or has already resulted in infertility.
2.
When there is pain that cannot be alleviated with medication.
Response from Dr.
Hsu Wei-Kai, Director of Urology, Taitung Hospital, Department of Health, Executive Yuan.

Reply Date: 2006/09/05

More Info

Dear Patient,
Thank you for your inquiry regarding varicocele and its impact on fertility. Varicocele is a condition characterized by the enlargement of veins within the scrotum, similar to varicose veins that can occur in the legs. It is a common condition, affecting approximately 15% of the male population, and is often associated with male infertility.

1. Impact of Poor Sperm Motility on Fertility: Sperm motility is crucial for fertility, as sperm must swim through the female reproductive tract to reach and fertilize the egg. A motility rate of 46% is considered below the normal threshold, which is typically around 50% or higher for optimal fertility. Poor sperm motility can indeed affect the chances of conception, as it may hinder the sperm's ability to reach the egg. In cases of significant motility issues, assisted reproductive technologies (ART) such as in vitro fertilization (IVF) may be recommended.

2. Surgical Intervention and Improvement: Surgical treatment for varicocele, known as varicocelectomy, involves the ligation of the affected veins to redirect blood flow and reduce venous pressure. Studies have shown that varicocelectomy can improve sperm parameters, including motility, in many men with varicocele. The degree of improvement varies among individuals, but many experience enhanced fertility potential post-surgery. If you are considering this option, it is essential to discuss it with a urologist or a fertility specialist who can evaluate your specific situation and provide personalized recommendations.

3. Pain and Surgical Necessity: Occasional pain in the left side, where varicoceles are most commonly found, can be a symptom of the condition. While not all varicoceles require surgical intervention, persistent pain or discomfort may warrant surgical evaluation. If the pain is affecting your quality of life or is associated with other symptoms, it is advisable to consult with a healthcare provider. They can perform a physical examination and possibly recommend imaging studies to assess the severity of the varicocele and determine the best course of action.

In summary, varicocele can impact fertility, particularly through its effects on sperm motility. Surgical options are available and may improve sperm parameters, potentially enhancing fertility. If you are experiencing pain or discomfort, it is crucial to seek medical advice to determine the appropriate treatment.
Please feel free to reach out if you have further questions or need additional information. Your health and well-being are of utmost importance, and I wish you the best on your journey toward parenthood.

Best regards,
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