Men who have been diagnosed with a varicocele and are experiencing issues with infertility, might be looking for information about treatment options and whether fertility after varicocele surgery is even possible.

Before deciding on which varicocele treatment option is right for you, it is important to understand about varicoceles:

• Varicoceles are thought to play a role in infertility in about 35% of men with primary infertility.
• Varicoceles, or dilated veins in the scrotum and around the testicles, are present in 15% of men.
• A varicocele can cause 2 types of problems: infertility and discomfort. This discomfort may also be described as pain or heaviness in the scrotum or around the testicles.

One of the reasons men consider varicocele surgery is to treat infertility. Your surgeon will talk to you and will determine if fertility after varicocele surgery can be achieved. Varicocele surgery to treat infertility will likely be recommended if:

• The varicocele can be felt by the surgeon.
• The definition of infertility has been met.
• The male partner has low semen quality, count or abnormal sperm function.

When a varicocele requires treatment there are several available options:

1. Open microsurgical varicocele ligation

This procedure involves using an operating microscope to magnify the operative field and then a small incision is made in the groin. The spermatic cord, which carries the testicular veins, is identified and the veins are then separated from all the other important structures in the spermatic cord. The veins are then individually ligated.

2. Radiological embolisation

This involves a procedure performed by an interventional radiologist. A puncture is made in the femoral blood vessels and coils are used to embolise the testicular vein.

The treatment of a varicocele as part of the treatment of male infertility is a controversial subject. There are some studies which have shown a benefit in the overall pregnancy rate from treating it, whereas others have shown a benefit in the semen parameters but no significant benefit in the pregnancy rate. Here at London Andrology we assess each case individually to see whether treating the varicocele will be beneficial to the patient. We offer all the treatment options available, including microsurgery.

Fertility after varicocele surgery can be improved as it may achieve the following:

• Sperm count and sperm quality may improve.
• Testosterone levels may return to normal.
• Pain related to a varicocele may be improved.

To book an appointment please contact us to arrange a consultation.