Varicoceles are a condition where the veins that are located in the blood vessels of the scrotum are enlarged or dilated. Typically the veins in the scrotum have valves which control the flow of blood.
In some cases, these valves are missing or they are defective. This inhibits the blood from circulating efficiently through the testicles. This then causes the veins behind and above the testicles to swell.
About 80 percent of varicoceles will develop in the left testicle. Once varicoceles have been treated there is generally no need for any type of medication that needs to be taken to increase sperm count.
Varicoceles and Your Fertility
Studies show that varicoceles are evident in about 20 percent of fertile men and up to 40 percent of infertile men. What this indicates is that just having a varicocele doesn’t make you infertile.
However what does lead to infertility may be a combination of factors. There is some evidence that sperm can be damaged when there is an increase in temperature in the testes.
This increase in temperature may also deter the production of healthy and mobile sperm.
Yet another theory is that men who have varicoceles may also have testicular fluid that has high concentrations of chemicals that can harm and damage the sperm.
These chemicals are known as ROS (reactive oxygen species).
Diagnosis of varicoceles is done through a physical examination. While the patient stands up the scrotum is inspected to determine if there is a varicocele.
Some men may detect a varicocele on their own after exercising or standing for a prolonged period of time. If necessary an ultrasound can be done to detect any smaller varicocele.
However, research shows that these smaller varicoceles are not likely to affect fertility. Most men, other than experiencing fertility problems, may show no signs of varicoceles.
Some symptoms that may become apparent include:
- Shrinkage of the testicle(s).
- Heaviness in the testicle(s).
- Testicular discomfort and/or pain.
- A visible vein that is enlarged.
Any pain with varicoceles will usually be mild to moderate and often occurs after long periods of standing, sitting, or exercising.
Can Varicoceles Be Treated and Increase Fertility?
For most men, varicoceles will be treated by using a surgical procedure known as a varicocelectomy, where the affected veins will be tied off.
The following methods of treatment are used for a varicocelectomy:
- Surgical Ligation: General anaesthesia is used for this procedure. The surgeon will make a 2 to 3-inch incision in the abdomen area. Once the affected veins are found they’ll be cut through and tied off. Surgical ligation is usually done as an outpatient procedure and it takes about six weeks for a full recovery and for a couple to try to conceive.
- Laparoscopy: During this procedure, a laparoscope, or fibre optic telescope, is inserted in through a small incision in the belly button directly into the abdomen cavity. The surgeon will use a camera that is attached to the laparoscope to see what is happening. Once the affected veins are found they’ll be cut and tied off using tiny surgical instruments. These instruments are inserted in through a small incision close to the pubic hairline. It will take about two days for a full recovery.
Some surgeons will choose to use a non-surgical method of tying off the veins that are preventing blood flow. This includes:
- Embolization: While general anaesthesia is not needed for this procedure the patient may be sedated for comfort. A tiny catheter will be inserted into the veins that are located right below the varicocele. The catheter is then guided by x-ray as the surgeon uses a colored dye to pinpoint the varicocele. This is also known as venography. Very tiny coils are then threaded through the catheter. These coils will then stop the flow of blood to the enlarged veins. Full recovery is expected in two days.
There really is no evidence that any one of the above procedures is better than another. Many men will choose a treatment based on the amount of recovery time that works best for them.
Couples who are having infertility problems may choose embolization as this procedure is less invasive than the surgical methods of treatment.
Will Varicocele Repair Boost Fertility?
Varicocelectomies are often done to increase male infertility since varicoceles seem to damage and destroy the sperm. While some studies show that repairing the varicoceles can boost pregnancy rates, other studies aren’t as conclusive.
While there is no substantial proof that varicocele repair will improve your fertility there is enough evidence to show that larger varicoceles are linked to some sperm problems.
Since a varicocelectomy is relatively painless and easy to perform, many infertility specialists are recommending surgery for varicoceles in order to increase a couple’s chances of getting pregnant.
Keep in mind that if after a varicocelectomy you’re still having problems conceiving, that there may be some other medical issues that will need to be looked at.