Varicocele

A varicocele is a cluster of enlarged veins in the scrotum, around the testicle. The enlarged veins belong to the pampiniform plexus, the network of veins around the testicle. Varicoceles occur in about 12% of men with normal semen tests. They occur in about 40% of men with primary infertility and 80% of men with secondary infertility.¹ Healthy veins help keep the testicles cooler than the rest of the body. Enlarged veins let the testicles overheat. The extra heat slows sperm production. It also raises oxidative stress, a form of cell damage. This damage can harm sperm DNA and lower sperm count and motility.²

A varicocele is a common cause of male factor infertility that surgery can correct. Repair improves semen test results in most men.¹³⁴⁵ Repair also improves the integrity of sperm DNA, measured as sperm DNA fragmentation.⁶ Surgeons can repair a varicocele in several ways. Surgery through a small incision in the groin, done under a microscope, gives the best results. It also has the lowest rates of hydrocele, fluid buildup around the testicle, and of recurrence of the veins.¹

Varicocele is also linked to OAT syndrome, in which sperm are few, slow, and abnormally shaped. It plays a part for some couples facing infertility. Restorative andrology evaluates the male partner for varicocele as part of a couple-based workup. The goal is to find and correct the cause instead of bypassing it with sperm extraction. and oxidative stress.