In plain words
A varicocele is a cluster of enlarged veins in the scrotum, usually on the left side. It is common in men, and many have no symptoms. It is found most often during tests for . A varicocele can affect by warming the testicle and changing blood flow. Some men feel a dull ache or heaviness. Repair is an option for some men with abnormal semen results and a clinical varicocele. The benefit for pregnancy rates is debated, and the decision is made with a urologist or fertility specialist.
The deeper version
Varicocele is of the pampiniform plexus, found in about 15 percent of adult men and in a higher share of men evaluated for infertility. Proposed mechanisms include testicular hyperthermia, hypoxia, of toxic metabolites, and altered Leydig function. The AUA and ASRM male infertility guideline (2020) recommends varicocelectomy for men with a clinical varicocele and abnormal semen parameters in the context of infertility, and advises against repair of subclinical varicocele in men without abnormal semen parameters. Pregnancy benefit from repair is debated: randomized trials show variable effects on sperm parameters and inconsistent improvement in live birth rates. The WHO laboratory manual (2010) sets the semen reference values used to judge abnormality.
Where it comes up
- Trying to conceive: how long is normal, when to ask for helpBefore Pregnancy
- Your partner's health before conceptionBefore Pregnancy
- The preconception visitBefore Pregnancy
- Infertility and the long roadLoss and Complications
What mothers here say about varicocele
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Sources
- American Urological Association and American Society for Reproductive Medicine — Male Infertility: AUA/ASRM Guideline, 2020
- World Health Organization — WHO Laboratory Manual for the Examination and Processing of Human Semen, 5th edition, 2010
- American Society for Reproductive Medicine — Varicocele and male infertility: a committee opinion, 2014