Can Surgery Restore Fertility After Testicular Atrophy Due to Varicocele?

Testicular atrophy

Hello, during the premarital health check, it was found that my fiancé has azoospermia.
After consulting a urologist, the doctor mentioned something about varicocele causing severe testicular atrophy, but he does not experience any pain.
If he undergoes surgical treatment, will he still have fertility? We are very concerned.

888, 30~39 year old female. Ask Date: 2015/09/24

Dr. Xu Weikai reply Urology

Hello, if testicular atrophy is caused by varicocele and surgery is performed, the recovery of function will depend on the extent and duration of the impact.
However, if surgery is not performed, the condition will only worsen.
Therefore, I personally recommend that if the clinical physician believes surgery is necessary, you should follow their advice.
As for whether it affects fertility, semen analysis and male hormone testing can be conducted.
This is a response from Dr.
Hsu Wei-Kai, Director of Urology, Taitung Hospital, Ministry of Health and Welfare.

Reply Date: 2015/09/24

More Info

Surgery can indeed restore fertility after testicular atrophy due to varicocele, but the success of the procedure depends on several factors, including the severity of the atrophy, the age of the patient, and the duration of the varicocele. Varicocele is a condition characterized by enlarged veins within the scrotum, which can lead to decreased sperm production and quality, ultimately affecting fertility.

When a varicocele is present, it can cause increased temperature in the testicles and disrupt the hormonal balance necessary for sperm production. Over time, this can lead to testicular atrophy, where the testicles shrink and produce fewer sperm. In cases where there is no sperm present in the ejaculate (a condition known as azoospermia), surgical intervention may be necessary.

The most common surgical procedure for varicocele is called varicocelectomy, which involves the ligation of the affected veins to redirect blood flow and reduce the pressure in the scrotum. This can help restore normal testicular function and improve sperm production. Studies have shown that varicocelectomy can lead to significant improvements in sperm parameters and, in many cases, can result in successful pregnancies.

However, it is important to note that the extent of recovery can vary. If the testicular atrophy is severe and has been present for a long time, there may be irreversible damage to the testicular tissue, which could limit the potential for sperm production even after surgery. In such cases, assisted reproductive technologies (ART), such as in vitro fertilization (IVF) with sperm retrieval techniques, may be considered.

In terms of timing, it is generally recommended to wait for a period of time after surgery to allow for recovery and for sperm production to normalize. This period can vary but is often around three to six months. During this time, follow-up semen analyses can help assess the recovery of sperm production.

Additionally, lifestyle factors can also play a role in fertility. Maintaining a healthy weight, avoiding tobacco and excessive alcohol consumption, and managing stress can all contribute to improved fertility outcomes. It may also be beneficial for your fiancé to consult with a fertility specialist who can provide personalized recommendations based on his specific situation.

In conclusion, while surgery for varicocele can restore fertility after testicular atrophy, the success of the procedure depends on various factors. It is essential to have realistic expectations and to work closely with healthcare providers to determine the best course of action for achieving pregnancy. Regular follow-ups and semen analyses post-surgery will be crucial in monitoring recovery and fertility potential.

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