Varicocele: Impact on Semen Quality and Fertility

Q: Varicocele: Impact on Semen Quality and Fertility

Mr. X： Hello. 1. Poor physical condition can lead to decreased semen quality and even infertility. 2. Varicocele can cause an increase in testicular temperature, affecting testicular development. The longer the condition persists, the greater the impact. <

Varicocele

Hello, I would like to ask: Last week, I had an ultrasound at the urology department, and the doctor mentioned that there is a significant dilation of the left spermatic vein, while the right side is only very mild.
Additionally, blood tests and a semen analysis were arranged.
This morning, I submitted my semen sample, but I was feeling anxious about the tests, which caused me to have trouble sleeping and wake up very early, so I ejaculated in a very fatigued state.
I even experienced ejaculation without a full erection and am unsure if I fully expelled the semen (this is not typical for me).
I would like to know if ejaculating in a fatigued state affects semen quality (quantity? motility?).
If it does, should I request a retest during my next appointment? Also, if the dilation of the spermatic vein is not surgically addressed immediately but is postponed for a few years, will this decrease the chances of successful recovery of fertility post-surgery? If I plan to conceive several years later, should I consider surgery now regardless of whether the semen analysis results are normal or abnormal? (Currently, I do not experience any discomfort or disruption to my daily life.) Thank you.

Mr. X, 20~29 year old female. Ask Date: 2013/08/01

Dr. Xu Weikai reply Urology

Mr.
X: Hello.
1.
Poor physical condition can lead to decreased semen quality and even infertility.
2.
Varicocele can cause an increase in testicular temperature, affecting testicular development.
The longer the condition persists, the greater the impact.
3.
Whether to proceed with surgery is your decision.
If there are any unclear points, feel free to ask again, and we can discuss and research further.
Online responses should only be used as a reference; it is essential to seek medical care at a healthcare facility if necessary.
This message is from Dr.
Hsu Wei-Kai, Chief of Urology, Taitung Hospital, Department of Health, Executive Yuan, who cares about your well-being.

Reply Date: 2013/08/01

More Info

Varicocele is a condition characterized by the enlargement of veins within the scrotum, similar to varicose veins that occur in the legs. It is a common condition, affecting approximately 15% of the male population, and is often found in men who are evaluated for infertility. The left side is more commonly affected due to anatomical differences in venous drainage.
The presence of a varicocele can have a significant impact on semen quality and fertility. Research indicates that varicoceles can lead to decreased sperm production, reduced sperm motility (the ability of sperm to swim), and abnormal sperm morphology (shape). These factors can contribute to male infertility, making it more challenging for couples to conceive. The exact mechanism by which varicoceles affect sperm quality is not fully understood, but it is believed that increased temperature in the scrotum, hormonal imbalances, and oxidative stress may play a role.

Regarding your concerns about the recent semen analysis, it is important to note that several factors can influence the quality of a semen sample, including stress, fatigue, and the method of ejaculation. If you were in a fatigued state and experienced difficulty achieving full erection during ejaculation, it is possible that this could affect the sample's quality. Specifically, fatigue can lead to reduced sperm count and motility. If you have concerns about the accuracy of this sample, it would be reasonable to discuss with your doctor the possibility of repeating the semen analysis under more optimal conditions.

As for the timing of potential surgical intervention for varicocele, the decision to proceed with surgery often depends on several factors, including the severity of the varicocele, the results of semen analysis, and the couple's plans for future fertility. If the varicocele is causing significant issues with sperm quality, surgical correction (typically via varicocelectomy) may improve semen parameters and enhance fertility potential.
If you are not currently experiencing discomfort or significant issues related to the varicocele, and if your semen analysis results are normal, you may choose to monitor the situation. However, if you plan to conceive in the near future and the semen analysis shows abnormalities, it may be advisable to consider surgical intervention sooner rather than later.
In summary, varicocele can negatively impact semen quality and fertility. Factors such as fatigue and stress can also affect semen analysis results. If you have concerns about the quality of your sample, discussing a repeat analysis with your healthcare provider is a good idea. Finally, the timing of surgical intervention should be based on your fertility goals and the current state of your semen quality. Consulting with a urologist or a fertility specialist can provide tailored advice based on your specific situation.

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