Men with varicoceles with testicular atrophy respond to varicocele repair

The reproductive urologists, Dr. Parviz Kavoussi and Dr. Luke Machen, at Austin Fertility & Reproductive Medicine presented their research on varicocele repair in men with testicular atrophy at the 2019 American Society for Reproductive Medicine national meeting and congress.  A varicocele is an abnormal dilation of veins around the testicle which increase testicular temperatures and are adverse for male fertility and are present in 40% of infertile men. Varicoceles have been shown to decrease sperm counts, motility (ability of sperm to swim), morphology (number of sperm with normal shapes) as well as increasing sperm DNA damage which can result in lower fertilization rates, pregnancy rates, and can increase miscarriage rates.  Some men with varicoceles have severe enough testicular damage from the varicocele that it can cause the testicle to shrink in size, which is known as atrophy.  A minor, but technically demanding microsurgery to repair the varicocele has been well proven to increase overall semen analysis parameters in the majority of patients and decrease sperm DNA damage in nearly all men.

The group at AFRM investigated the outcomes of men who underwent varicocele repair when the man had testicular atrophy versus when the man did not have testicular atrophy on the same side as the varicocele.  The findings including improvement in both groups overall but a statistically significant improvement in all semen parameters and DNA fragmentation in men without atrophy and a statistically significant improvement in DNA fragmentation in men with atrophy. Dr. Kavoussi states, “This data can assist in our ability to counsel our patients on how much response they may be able to expect with varicocele repair depending on if they have atrophy on the side of the varicocele or not”.