A varicocele is an abnormal dilation of scrotal veins around the testicle and can decrease sperm counts, sperm motility, and morphology. Varicoceles can also cause increased damage to the DNA of sperm cells, having an adverse impact on fertilization, pregnancy, and miscarriage rates. Fifteen percent of men in the general population have a varicocele and 40% of men presenting for infertility have a varicocele, which makes varicocele the most common correctable form of male subfertility. One percent of men in the general population and 15% of men presenting for infertility have a sperm count of zero, known as azoospermia. This adds up to a number of men with azoospermia and varicoceles.
Dr. Parviz Kavoussi, a renowned expert in male infertility provides care for a large number of men with varicoceles and with azoospermia at Austin Fertility & Reproductive Medicine/Westlake IVF. He has contributed a chapter on varicoceles and azoospermia to the Springer published textbook of Varicocele and Male Infertility. Dr. Kavoussi states, “Although these are complex scenarios, it is always recommended that a man with a sperm count of zero without a blockage as the cause, who has a varicocele has that varicocele repaired as 20-40% of these men will have return of sperm to the semen several months after repair of the varicocele. In men who do not have return of sperm to the semen after varicocele repair, and have to go through the next step of microdissection testicular sperm extraction, a meticulous microsurgical search for sperm in the testicle to be retrieved for use with IVF, the odds of retrieving sperm increase after the varicocele has been repaired. There will also be healthier sperm retrieved with better outcomes with IVF after the varicocele has been repaired if microdissection testicular sperm extraction is required.”
Dr. Kavoussi performs multiple varicocele repairs every week and performs microdissection testicular sperm extractions regularly with excellent outcomes in both.