The most common correctable cause of male infertility is a varicocele, abnormally dilated veins of the pampiniform plexus that surround the testicle and are adverse for sperm. It has been established that varicoceles can decrease sperm counts, motility, and morphology and increase sperm DNA damage rates in some men and that in most men surgical repair of the varicocele can improve these factors. Dr. Parviz Kavoussi repairs multiple varicoceles a week and has recently published a study discussing varicocele management, some of the inconsistencies and gaps in knowledge. Dr. Kavoussi states, “Although the majority of us are fairly aggressive about repairing varicoceles in infertile men with poorer sperm parameters or high levels of DNA damage, there are other factors we do not test clinically that varicoceles have been shown in research studies to impact such as inflammatory proteins, reactive oxygen species, oxidative stress, and lipid peroxidation which has been shown to be bad for sperm function. There are also discrepancies in practice patterns on varicocele approaches.”
Read the full article: Varicocele and male infertility conundrum: Making sense of a never-ending story for the busy clinician
