Varicocele and Male Infertility: Latest Treatment Options That Work

What Is Varicocele?

A varicocele is an abnormal enlargement of the veins inside the scrotum, similar to varicose veins in the legs. These dilated veins disrupt normal blood flow from the testicles, leading to increased scrotal temperature and impaired testicular function.

This condition can negatively affect sperm production, quality, and hormonal balance, making it one of the most common reversible causes of male infertility.

Prevalence:

1. Affects approximately 15% of all men
2. Found in up to 40% of men diagnosed with infertility

How Varicocele Impacts Fertility

Varicocele can compromise fertility through multiple mechanisms:

1. Reduced Sperm Count – Poor blood drainage can limit sperm production.
2. Poor Sperm Motility – Heat stress damages the tail function needed for movement.
3. Abnormal Sperm Morphology – High temperature and oxidative stress alter shape and DNA quality.
4. Hormonal Disruption – May impair testosterone production, affecting libido and sperm development.

Symptoms and Diagnosis

Many varicoceles are symptom-free and detected only during a fertility evaluation. When symptoms do occur, they may include:

1. Dull, aching scrotal pain (worsens after prolonged standing or exercise)
2. Visible or palpable enlarged veins (often described as a “bag of worms” sensation)
3. Shrinkage (atrophy) of the affected testicle

Diagnostic Methods:

1. Physical Examination – Performed by a urologist while standing and during Valsalva manoeuvre
2. Scrotal Ultrasound – Confirms vein dilation, grades severity, and assesses testicular size

Latest Treatment Options for Varicocele (2025)

Treatment is generally recommended if a varicocele is linked to:

1. Abnormal semen analysis
2. Infertility
3. Discomfort or testicular pain
4. Testicular shrinkage

Modern treatment methods include:

1. Microsurgical Varicocelectomy

1. Performed via a small incision using an operating microscope for high precision
2. Highest success rates and lowest recurrence rates among all techniques
3. Usually done under local or general anaesthesia
4. Recovery: Return to normal activities in 1–2 weeks

2. Laparoscopic Varicocelectomy

1. Minimally invasive procedure with small abdominal incisions
2. Suitable for bilateral varicocele repair
3. Shorter recovery but slightly higher recurrence than microsurgery

3. Percutaneous Embolisation

1. Non-surgical approach performed by an interventional radiologist
2. A catheter is inserted into a vein and tiny coils or agents are used to block abnormal blood flow
3. Local anaesthesia only, same-day discharge
4. Not suitable for all varicocele types

Expected Fertility Outcomes

1. Semen Quality:
2. Noticeable improvements in sperm count, motility, and morphology often occur within 3–6 months post-treatment.
3. Pregnancy Rates:
4. Studies report 30–50% spontaneous pregnancy rates after successful repair in couples with no other infertility factors.

When to Seek Treatment

You should consider evaluation and treatment if:

1. Your semen analysis shows abnormalities linked to varicocele
2. You and your partner have tried to conceive for 12+ months without success
3. You experience persistent testicular discomfort
4. You notice testicular atrophy on one side

Lifestyle and Supportive Measures

While treatment addresses the underlying cause, lifestyle changes can help maximise fertility potential:

1. Maintain a healthy weight
2. Avoid prolonged heat exposure (e.g., saunas, hot tubs)
3. Limit alcohol consumption and quit smoking
4. Eat a nutrient-rich diet high in antioxidants (vitamin C, vitamin E, zinc, selenium)

Final Thoughts: A Treatable Cause of Male Infertility

Varicocele is a common yet often reversible cause of male infertility. Thanks to advances in microsurgery, laparoscopy, and minimally invasive embolisation, treatment is safer, more precise, and more effective than ever before.

With proper diagnosis and a personalised treatment plan, many men experience significant improvements in sperm health—and couples increase their chances of natural conception.

At the clinic of Assoc. Dr. Nurettin Türktekin, we offer:

1. Comprehensive male fertility assessments
2. State-of-the-art varicocele repair techniques
3. Ongoing support to help you achieve your family goals

Contact us today to schedule your consultation and find the best treatment path for your needs.