Varicocele

A fairly common infertility problem resulting in male fertility problems, varicocele refers to the presence of varicose veins in the testicles. This condition is thought to affect 15% of the general male population but as much as 40% of all infertile males. Varicoceles tends to occur more often in men experiencing secondary infertility.

How Does Varicocele Affect Fertility?
As with most other varicose veins, varicoceles occurs when blood in the testicles does not circulate out properly. As a result, this excess blood causes the temperature in the testicles to rise leading to abnormal testosterone levels. This increased temperature in the scrotum then prevents the proper production and maturation of sperm thereby lowering a man’s fertility.

Although it is possible for varicocele to affect both testicles, about 90% of the time it is just the left side that is affected. While experts aren’t exactly sure why it is almost always the left testicle that develops the varicose veins, the fact that there are 40% fewer valves in the left spermatic vein, which is also as much as 8 to 10 centimeters longer than the spermatic cord in the right testicle, is one possible reason. Additionally, the left spermatic vein has more pressure placed on it than the right, which may cause it to be more prone to blockages.

Varicoceles Symptoms
Often times, men affected by varicocele will not produce any visible signs. On occasion, though, a man may experience one or more of the symptoms associated with varicocele, which can include:

• Testicular pain or discomfort
• Noticeable shrinkage of the testicle(s)
• A heavy feeling in the testicle
• Infertility
• An enlarged vein that can be found by touch or sight

Veins that have become significantly enlarged will likely be visible. However, small or medium sized veins may only be identifiable through touch.

Diagnosing Varicocele
Many incidents of varicocele are diagnosed during physical examinations. However, in cases where varicoceles is suspected but none can be found by sight or touch, an ultrasound or venography (whereby dye is injected into the vein and then x-rayed) diagnostic test may be performed.

In some cases, a sperm analysis may also alert your fertility specialist to the presence of varicose veins in your testicles. Upon examination, a semen analysis can reveal sperm that is immature, damaged, has abnormal morphology or motility, is dying, or dead. It can also indicate decreased sperm count, another effect of varicocele.

Treatment is available for varicocele. Most often, this involves surgery to restore fertility.

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