Approximately 1% of men in the general population in the United States have a sperm count of zero. It is remarkably common considering that is one out of every 100 men. Fifteen percent of men in the general population have a varicocele, an abnormal dilation of veins around the testicle which can adversely impact sperm production and sperm health. That being said, there are a fair number of men who have both a sperm count of zero and a varicocele. Dr. Parviz Kavoussi published a study revealing that varicoceles can induce such severe testicular injury in some men that they can drop the sperm count down to zero and induce the most devastating testicular architectural changes in the testicle known as a Sertoli cell only histological pattern.
The good news is that in most cases there are options with reasonable success rates. The first step is repairing the varicocele to stop further damage and provide a 20-40% chance that just by repairing the varicocele, sperm returns to the semen. In the majority of men who do not have that happen, there is the option for the next step, microdissection testicular sperm extraction (microTESE). MicroTESE is a high level, meticulous, microsurgical search through the testicle looking for sperm, the needle in the haystack so to speak. When sperm is found it can be used with IVF/ICSI for conception.
To read Dr. Kavoussi’s publication on varicoceles inducing severe damage to the testicle click here