If you are having difficulty conceiving and doctors cannot offer a reason, it’s natural to feel worried and unsure. Varicocele is one of the important factors which can be solved. Proper diagnosis and management are important. Although not all men notice symptoms, a varicocele can still significantly affect reproductive health. Learning about varicoceles and the treatments available can help with planning your fertility journey.
What Is a Varicocele?
A varicocele happens when the veins in your scrotum swell and become enlarged. Varicose veins in your leg can give you an idea of how this problem develops, but here it’s in your scrotum. The pampiniform plexus keeps the blood supplied to your testicles chilled, which is necessary for healthy sperm creation.If these veins get larger, it slows blood circulation and makes the scrotum warmer, as well as causes an accumulation of excess metabolites. These conditions may impair optimal sperm development.
How Common Is Varicocele?
Many people don’t realise that varicocele affects about 15% of all men and up to 40% of men experiencing infertility. Varicocele is typically observed around puberty and is most common on the left side of the scrotum, although it may also appear on both sides.Even though not all men with a varicocele have trouble with fertility, it is considered one of the most common treatable causes of male infertility.. That’s why recognising and treating varicocele can make a significant difference in your chances of conception.
How Does Varicocele Affect Fertility?
If you have a varicocele, the most significant issue is the way it can impair sperm production and quality. The elevated temperature and poor blood drainage can lead to:- Lower sperm count
- Poor sperm motility (movement)
- Abnormal sperm morphology (shape)
- Increased oxidative stress, which can damage sperm DNA
Symptoms to Watch Out For
Many men with varicocele experience no symptoms and may only discover the condition during a fertility evaluation. However, you might notice signs such as:- A dull, aching pain or heaviness in the scrotum, especially after standing or physical activity
- Noticeably enlarged veins in the scrotum (often described as feeling like a "bag of worms")
- Shrinking of the affected testicles
- Discomfort that worsens over the day
Diagnosis: How Is Varicocele Identified?
The process of diagnosing varicocele typically begins with a physical examination. Your doctor may ask you to stand and bear down (the Valsalva manoeuvre) to make the varicocele more apparent.To confirm the diagnosis and assess severity, you may also undergo:
- Scrotal ultrasound: This imaging test provides a detailed view of the scrotum and its veins, allowing for the measurement of blood flow.
- Semen analysis: This helps evaluate sperm count, motility, and morphology, all of which can be affected by varicocele.
Treatment Options for Varicocele
Not all varicoceles need treatment. If you’re not experiencing symptoms and aren’t trying to conceive, your doctor may recommend observation. But if fertility is a concern, treatment may be the key to improving your reproductive outcomes.1. Surgical Varicocelectomy
This is the most common treatment for varicocele, especially when fertility improvement is the goal. In this procedure, the surgeon ties off the affected veins to redirect blood flow through healthier veins. There are several surgical approaches, including:- Open surgery (inguinal or sublingual)
- Laparoscopic surgery
- Microsurgical varicocelectomy generally offers the highest success rates and a lower risk of complications.
2. Percutaneous Embolisation
If you prefer a less invasive option, embolisation is a radiologic procedure where a small coil or solution is used to block the problematic veins. It’s done through a catheter inserted into a vein in your groin or neck and guided to the varicocele.While recovery is generally quick, embolisation might not be available in all healthcare settings and may have a slightly lower success rate than microsurgery.
Does Treatment Improve Fertility?
You’re likely wondering whether treating your varicocele will truly boost your chances of fathering a child. Studies have shown that varicocelectomy can lead to:- Improved sperm concentration and motility
- Decreased levels of oxidative stress
- Increased chances of natural conception
- Better outcomes with assisted reproductive techniques (ART) like IVF and ICSI
Post-Treatment Expectations
After treatment, expect gradual improvements in sperm count, motility, and morphology within 3 to 6 months. Regular follow-up appointments, including semen analyses and ultrasounds, are essential to monitor progress and ensure the treatment is working effectively.Lifestyle Tips to Support Fertility
While treating varicocele is a significant step, you can support your fertility by adopting healthy habits:- Maintain a healthy weight: Obesity can worsen hormone imbalances.
- Avoid excessive heat exposure: Hot baths, saunas, and tight underwear can negatively impact sperm production. Light to moderate exercise can improve overall health, but intense workouts that raise scrotal temperature may be counterproductive.
- Limit alcohol and tobacco: These substances are linked to poor sperm quality.
- Eat a balanced diet: Rich in antioxidants like zinc, selenium, and vitamin C.
By understanding the condition and taking proactive steps, whether through surgery, embolisation, or lifestyle changes, you can move closer to achieving your goal of parenthood. Speak with a urologist or fertility specialist to better understand your options.
FAQs on Understanding Varicocele and Its Treatment for Improving Male Fertility
- Can a varicocele come back after treatment?
Yes, while recurrence is uncommon with microsurgical techniques, it can happen. The likelihood of recurrence is higher with non-microsurgical or embolisation procedures. Regular follow-ups help monitor and address any issues early. - Is varicocele always associated with infertility?
Not necessarily. Many men with varicocele can conceive without treatment. However, if you’re experiencing difficulty conceiving, it's essential to evaluate whether varicocele might be contributing to the problem. - Are there any risks or side effects from varicocele surgery?
Like any surgery, varicocelectomy carries risks, including infection, hydrocele (fluid buildup), and damage to surrounding structures. However, these are relatively rare when the procedure is performed by an experienced surgeon using microsurgical techniques.
