What is varicocele? Varicocele is the presence of varicose or dilated veins in the scrotum. About 15 percent of men have this disorder. Even though for some men it does not cause any problems, almost 40 percent of infertile men have varicocele. Given that it increases the temperature of the testicles, varicocele con affect fertility […]
What is varicocele?
Varicocele is the presence of varicose or dilated veins in the scrotum.
About 15 percent of men have this disorder. Even though for some men it does not cause any problems, almost 40 percent of infertile men have varicocele.
Given that it increases the temperature of the testicles, varicocele con affect fertility in several ways:
• It causes oligospermia, that is a low sperm concentration on the ejaculate
• It reduces sperm motility (astenozoospermia) and prevents them from moving to the egg
• It generates changes in sperm morphology (teratozoospermia)
Main symptoms of varicocele
Although varicocele can be asymptomatic, it usually manifests itself through:
• Enlarged and twisted veins in the scrotum
• Inflammation of the scrotum
• Presence of painless testicular tumors
• Sensation of heaviness or pain in the testicles, especially when standing
• Size difference between both testicles
It is important to mention that varicocele on the left side is more common than on the right side (about 80 percent of the cases).
Causes of of varicocele
Veins on the testis (just like on the legs) have valves that help blood to flow towards the heart. If these valves do not work properly, blood accumulates in the veins and causes them to dilate.
Varicocele usually develops slowly and it is most common in men between 15 and 25 years of age.
How is varicocele diagnosed?
In addition to the analysis of your medical history, it is necessary to undergo a genital examination that takes a few minutes and can reveal the presence of enlarged veins or other symptoms of varicocele.
It is also advisable to perform a sperm analysis to rule out problems of concentration, motility and morphology of the sperm.
Treatments to achieve pregnancy when suffering from varicocele include:
• Intrauterine insemination, in which the man´s previously capacitated sperm are introduced in the woman's uterus at the exact time of ovulation. This method is only recommended when when the woman is less than 35 years of age and there are not other infertility causing factors
• In vitro fertilization, which allows joining the egg and the best quality sperm in a laboratory dish and thus increases the likelihood of fertilization
• In vitro fertilization with intracytoplasmic sperm injection (IVF+ICSI), which consists of injecting a single sperm it directly in the cytoplasm of a mature egg with a microscopic needle. This technique offers the highest pregnancy rate because it avoids the sperm having to move to fertilize the egg
If there are no sperm in the ejaculate, it is possible to retrieve them by means of an epididymal aspiration or a testicular biopsy.
It is important to mention that nowadays surgery is not recommended because it does not revert the damage done by the varicocele.