There is absolutely no direct correlation between the presence of a varicocele and infertility. There is no doubt that about 40% of individuals who undergo investigation for infertility have been found to have varicoceles. But one has to know that there are many more individuals with varicoceles who go on to have normal sperm and have satisfactory pregnancy with their spouse. There are also many men who undergo varicocele surgery and yet fail to have normal sperm counts.
The questions remains, “what should one do with varicoceles”. There is no question that incidentally discovered varicoceles or varicoceles that produce no symptoms can be safely observed. All the data about testicular atrophy and decline in sperm counts are unproven and hypothetical facts put out by unscrupulous surgeons. Many men live their entire lives with varicoceles and do so without any undue problems.
Varicoceles continue to generate controversy among fertility experts. Despite conflicting evidence from various clinical studies, all the trials still recommend the surgical treatment of clinical varicoceles in men with infertility. However, it is incumbent on the surgeon to discuss the pros and cons of surgery for varicocele. A second opinion is not always a bad idea.
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