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Varicoceles can be a Cause of Male Infertility

Men who have an abnormal semen analysis will often be referred for an examination of the testicles to help understand the cause of the abnormal count.  During the examination of the testicles a varicocele is sometimes found.

What is a Varicocele?

A varicocele is a collection of dilated veins surrounding the testicle that increases the blood flow to the testicle and therefore increases its temperature. Sperm need a cool environment to properly develop.  A large varicocele warms the surrounding testicle and can interfere with the normal production of sperm as well as produce abnormalities of movement and shape.

A varicocele that is diagnosed by examination is often confirmed by the use of ultrasound.  Generally these tests are ordered by a urologist.

Available Treatments for Varicoceles

Treatment of a varicocele is controversial.  Generally only large varicoceles are repaired because these tend to yield better improvement in sperm quality after the surgery.  Another problem with varicocele repair is that at least several months are required to recover from the surgery and for new sperm to develop.  In situations where rapid fertility is desired, such as in a woman over 39 years, varicocele surgery is not recommended to avoid these delays.

Testicular Problems

Varicocele is a varicose vein in the scrotum that prevents sperm from developing properly and can be treated with surgery. Testicles that fail to descend from the abdomen into the scrotum during fetal development causes a higher internal body temperature and sperm production can be affected. Additional testicular problems include: blocked ejaculatory ducts and or a lack of vas deferens (the tube that carries sperm from the testicle through the penis). Ejaculatory problems can include retrograde ejaculation—when semen enters the bladder during orgasm rather than through the penis. This can be caused by diabetes, prostate or urinary issues and by some medications.