In a nutshell
This study examined the effect of subclinical varicocele repair on semen quality and pregnancy rates in infertile men.
Some background
A varicocele is an enlargement of veins within the testes. It occurs in about 15% of the general population and is a common cause of low sperm production and decreased sperm quality, which can cause infertility in men. A subclinical varicocele is a vein that cannot be felt through the skin and may go undiagnosed. Subclinical varicocele can be repaired by a technique known as embolization where the vein is tied with a coil to prevent further swelling. This type of repair is not as common as surgery to completely remove the vein.
Subclinical varicocele are not often repaired because it is unclear whether it improves pregnancy rates. Most of the time, only the clinical varicocele, or the ones that can be felt, are treated.
Methods & findings
A total of 337 men took part in this study. Two thirds of the men opted to have treatment to remove subclinical varicocele, while one third opted not to have treatment. Semen quality and hormone levels were measured before treatment and 6 months afterwards.
There was a significant improvement in sperm concentration and sperm motility in treated compared to untreated groups (sperm motility [ability of the sperm to move]: 47% in treated group, 32% in untreated). In addition, a hormone called follicle stimulating hormone (impairs sperm formation when elevated), was significantly lower in treated versus untreated groups. Furthermore, when the men were followed up 3 years after treatment, pregnancy rates were significantly greater in the treatment group (46%) compared to the untreated group (12%).
The bottom line
The authors concluded that repair of subclinical varicoceles leads to an improvement in semen quality and increased natural pregnancy rates.
The fine print
This study only examined one type of treatment to repair repair subclincal varicocele. Therefore, it is unclear if the same beneficial effects would be seen in men who receive other types of treatment.
What’s next?
If you are considering treatment for clinical varicocele, talk to your doctor about potential treatment of subclinical varicocele also.
Published By :
Urology
Date :
Apr 01, 2015
