Does a varicocelectomy improve male fertility and alter fertility treatment needs?

This study investigated if a varicocelectomy improves male fertility and affects the chosen fertility treatment.

They found that varicocelectomy improves male fertility and requires less invasive treatment strategies for infertility.

Male infertility can be caused by a number of factors. A varicocele is an enlargement of veins in the scrotum. It is thought that they cause infertility by impairing blood flow and causing damage to or killing sperm.

Varicocelectomy involves repairing veins and is important in the treatment of male fertility. Some men will undergo this procedure before a couple begins assisted reproduction. This includes IUI (intra-uterine insemination) and IVF (in vitro fertilization, where the egg is fertilized by the sperm outside of the body, and the embryo is inserted into the uterus). The decision on whether a couple will use IUI or IVF depends on several factors including the number of healthy sperm a man has. 

This study investigated whether varicocelectomy improves male fertility and affects the method of assisted reproduction selected.

This study included data from 373 men who underwent varicocelectomy. Total motile sperm count (TMSC) was measured before and after the procedure. Depending on the TMSC, patients were selected to undergo either IVF (TMSC less than 5 million), IUI (TMSC between 5 and 9 million) or natural pregnancy (TMSC greater than 9 million).

Varicocelectomy significantly increased the TMSC for all patients. Men in the lowest TMSC category (less than 5 million cells) had the greatest overall increase in TMSC. 58.8% of these patients that were initially suitable for IVF became suitable for (less invasive) IUI following varicocolectomy. 64.9% of patients initially recommended for IUI were ‘upgraded’ to natural pregnancy following the procedure. 

This study concluded that varicocelectomy improves male fertility and may reduce the need for invasive treatment strategies for infertility.

This study examines only male fertility. Although varicocolectomy improved male fertility, the study did not include measurements such as pregnancy rates. Pregnancy rates are an important consideration as it measures fertility success. 

If you have any concerns regarding male fertility, please discuss this with your physician.