Issues – Varicocele

Approximately 40% of all infertility cases are the result of a male related fertility issue. The single most common male infertility cause is unhealthy sperm with varicocele being a close second. It is estimated that almost 15% of all men suffer from varicocele while an additional 40% of these cases result in infertility. Varicocele is a medical condition that causes the veins within the scrotum (the loose sack of skin that houses the testicles) to become enlarged. This enlarged vein causes blood to build up raising the temperature of the testicles resulting in abnormal testosterone levels thereby causing the testicles to shrink and sperm production and quality to decrease. Hence the reason it is a major fertility problem.

Unfortunately, varicocele’s rarely have any discernable symptoms and is usually not diagnosed until it impairs fertility. Sometimes men will experience pain that ranges from a very dull intensity to a sharp shooting pain. Often the pain will increase throughout the day and with various activities such as sitting, standing, or any physical exercise. Men with varicocele have reported that the only way to get relief from this pain is to lie down flat on their back. However, if left undetected it can continue to grow and become enlarged eventually leading to a noticeably physical different appearance. If you feel or see any abnormal growths in your groin area, you should immediately seek medical attention.

Although the exact cause of varicocele is unknown it is believed that it is caused because the valves inside the veins of the spermatic cord (this carries blood to and from your testicles) prevent the blood from flowing properly and results in a backup of blood making the veins dilate (widen). A majority of varicocele cases are formed during puberty and 90% of the time it will be the left side that is affected. This is thought to be because the left vein has more pressure on it than the right making it more prone to blockages.

Men between the ages of 15 and 25 are at the greatest risk for developing a varicocele. Other than age, there really are no other risk factors associated with this condition. Luckily, this is an easily treatable condition. Once it is determined that you have a varicocele, this is usually diagnosed during a physical examination, your doctor may prescribe a scrotal support (jock strap) to help alleviate some of the discomfort felt or your doctor may decide surgery is the best option. A varicocelectomy will be performed. Once numbing medication has been given, an incision will be made in the lower abdomen and the abnormal vein will be tied off so that blood will flow into normal areas.

Another option is to undergo embolization. This procedure employs the use of a catheter. This catheter is inserted into a vein in your groin area until it reaches the varicocele. Once there a small coil passes from the catheter into the varicocele blocking the blood flow to the bad vein and re-routing it to other normal veins.
Surgical repair of a varicocele is usually the only method of repairing this particular type of fertility problem and sperm count and quality will be increased upon completion of this surgery. In fact, in 70% of men who opt for varicocele surgery, sperm count is dramatically improved and within two years of the surgery, 60% of couples have reported a successful pregnancy. However, if testicular shrinking (atrophy) is the end result of a varicocele, surgery will not rectify the problem unless it is done in early adolescence. Sadly, too many men don’t even know they have this problem and do not have the necessary surgery.