Varicoceles and Male Infertility

Men with varicoceles, or varicose veins in the scrotum, experience male infertility at higher rates than the general population.

A varicocele, or a cluster of varicose veins in the scrotum, is present in about 10% to 15% of men. Though mostly asymptomatic, varicoceles have been linked to male infertility. In fact, a 2014 study attributed 32% of all cases of male infertility to varicoceles.

In addition, a 2007 study performed at New York-Presbyterian Hospital/Weill Cornell Medical Center noted that varicoceles accounted for 35% of primary infertility cases (inability to conceive for the first time) and 80% of secondary infertility cases (inability to conceive again after a prior successful pregnancy). The study further concluded that the presence of a varicocele lowers testosterone levels.

If you or your partner have a varicocele and are struggling to become pregnant, it’s worth considering whether your varicose veins play a considerable role in your infertility.

What Causes a Varicocele?

Much like veins in the leg, veins in the testicles and scrotum carry blood back to the heart through a system of valves that push the blood upward. A valve that cannot pump the blood to the heart can result in a pooling of blood in the vein. This stagnant blood can cause the vein to swell, causing a varicocele.

The veins inside the scrotum play a vital role in fertility. A network of veins known as the pampiniform plexus cool down the blood before it flows to the testicular artery. However, when these veins become overheated, the testicles fail to produce healthy sperm, sometimes leading to infertility.

Most men with varicoceles experience no significant symptoms. In some cases, men may feel pain after sitting or standing for long periods, as this increases the pressure in the veins, or they may notice that the testicles are smaller in size.

A visual examination can diagnose a varicocele, since the condition resembles worms wrapped around the scrotum. In addition, an ultrasound or a special X-ray called a venogram can capture an image of the blood flow in the scrotum. In the latter test, a dye injected into the veins highlights any abnormalities in the blood vessels.

Treatments for Varicocele

Men diagnosed with varicoceles have several treatment options that may restore fertility. According to one study, men undergoing therapy for varicoceles showed increased sperm counts. However, it should be noted that other studies were inconclusive about whether treatments reversed infertility in men with varicoceles.

Men opting for treatment have two choices — embolization or surgery:

Catheter-directed Embolization. In this non-surgical, outpatient procedure, an interventional radiologist threads a catheter from the groin to the testicular vein. The doctor then cuts off the blood flow to the vein, allowing the blood to stream to healthier veins. Patients undergoing embolization usually recover in about two days.

Surgery. Surgical removal of the varicocele is called a varicocelectomy. This operation requires a general anesthetic, but patients can leave the hospital the same day. The recovery is longer than embolization, usually lasting about two to three weeks.

Do You Have a Varicocele?

At the Center for Vein Restoration, we can diagnose a variety of venous disorders for men and women. If you have a varicocele, contact us today for an appointment — we can help guide you through the diagnosis and treatment process.