The Role of Varicocele in Male Fertility

Publisher Website
Google Scholar
Abstract
In summary, seventeen infertile men with varicocele in whom no other cause for infertility could be identified, were studied before and following varicocele repair. Morphologic alterations were the most common abnormality noted in the seminal fluid with all subjects demonstrating increased numbers of tapered or amorphous spermatozoa. Ligation of the varicocele resulted in improvement in one or more of the seminal fluid abnormalities in thirteen of the seventeen patients. Seven patients achieved a pregnancy. No single seminal fluid parameter was identified which was of predictive value in determining those subjects who would demonstrate improvement following varicocele repair.The sperm count, morphology, and motility were analyzed in 17 men before and after correction of unilateral varicocele. In mean 3.7 seminal fluid specimens before surgery, 65 percent had sperm counts below 20 million/ml and counts increased 50 percent or up to normal range in 4. Reduced motility was observed in 57 percent before repair, and improved in 4 of 8 without affecting morphology. Differential morph ology by MacLeod's method revealed 12.7 percent amorphous forms (9 percent is upper limit of normal), i.e., an increase in tapered, duplicate, immature, and amorphous forms. After varicocele repair the proportion of oval forms increased in only 1/3 of the patients. 7 of the 17 men achieved a pregnancy within 5-15 months, including 1 man with no improvement in seminal fluid characteristics and 2 whose wives were treated with clomiphene.