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Varicocele and Infertility

  • Chapter
Office Andrology

Part of the book series: Contemporary Endocrinology ((COE))

Abstract

A 33-yr-old man has been trying to conceive for 1.5 yr with his 30-yr-old female partner. She is medically healthy, with a history of a terminated pregnancy 3 yr prior, has regular ovulatory cycles and a normal hysterosalpingogram. He has been evaluated by a urologist, which revealed that he is also medically healthy, with a grade III left varicocele and normal follicle-stimulating hormone (FSH) and testosterone levels. His semen analysis (repeated) consistently shows a normal ejaculate volume, a low-sperm concentration (16 million sperm/mL), low sperm motility (33% active), and poor strict morphology (5%). How should this couple be counseled regarding cost-effective treatment options? How would recommendations differ concerning varicocele repair if he had no sperm in the ejaculate?

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References

  1. Saypol DC. Varicocele. J Androl 1981;2:61–65.

    Google Scholar 

  2. Barwell R. One hundred cases of varicocele treated by the subcutaneous wire loop. Lancet 1885;1: 978–980.

    Article  Google Scholar 

  3. Bennet WH. Varicocele, particular with reference to its radical cure. Lancet 1889;1:261–262.

    Google Scholar 

  4. Jarrow JP. Effects of varicocele on male fertility. Hum Reprod Update 2001;7:59–64.

    Article  Google Scholar 

  5. Grillo-Lopez AJ. Primary right varicocele. J Urol 1971;105:540–543.

    PubMed  CAS  Google Scholar 

  6. Naughton CK, Nangia AK, Agarwal A, et al. Varicocele and male infertility: Part II. Pathophysiology of varicoceles in male infertility. Hum Reprod Update 2001;7:473–481.

    Article  PubMed  CAS  Google Scholar 

  7. Steeno O, Knops J, Declerck L, et al. Prevention of fertility disorders by detection and treatment of varicocele at school and college age. Andrologia 1976;8:47–53.

    Article  PubMed  CAS  Google Scholar 

  8. Cozzolino DJ, Lipshultz LI. Varicocele as a progressive lesion: positive effect of varicocele repair. Hum Reprod Update 2001;7:55–58.

    Article  PubMed  CAS  Google Scholar 

  9. Turner TT. Varicocele: Still an enigma. J Urol 1983;129:695–699.

    PubMed  CAS  Google Scholar 

  10. Shafik A, Moftah A, Olfat S, et al. Testicular veins: anatomy and role in varicocelogenesis and other pathologic conditions. Urology 1990;35:175–182.

    Article  PubMed  CAS  Google Scholar 

  11. Braedel HU, Steffens J, Ziegler M, et al. A possible ontogenic etiology for idiopathic left varicocele. J Urol 1994;151:62–66.

    PubMed  CAS  Google Scholar 

  12. Macleod J, Hotchkiss RS. The effect of hyperpyrexia upon spermatozoa counts in men. Endokrinologie 1941;28:780–782.

    Article  Google Scholar 

  13. Zorgniotti AW, Macleod J. Studies in temperature, human semen quality, and varicocele. Fertil Steril 1973;24:854–863.

    PubMed  CAS  Google Scholar 

  14. Goldstein M, Eid J. Elevation of intratesticular and scrotal skin surface temperature in men with varicoceles. J Urol 1989;142:743–745.

    PubMed  CAS  Google Scholar 

  15. Yin Y, Hawkins KL, deWolf WC, et al. Heat causes stress testicular germ cell apoptosis in adult mice. J Androl 1997;18:159–165.

    PubMed  CAS  Google Scholar 

  16. Fujisawa M, Yoshida S, Kojima K, et al. Biochemical changes in testicular varicocele. Arch Androl 1989;22:149–159.

    Article  PubMed  CAS  Google Scholar 

  17. Nishiyama H, Danno S, Kanneko Y, et al. Decreased expression of cold induced RNAbinding proteins (CIRP) in male germ cells at elevated temperature. Am J Pathol 1998;152:289–296.

    PubMed  CAS  Google Scholar 

  18. World Health Organization. The influence of varicocele on parameters of fertility in a large group of men presenting to infertility clinics. Fertil Steril 1992;74:1298–1202.

    Google Scholar 

  19. Hudson RW. Free sex steroid and sex hormone-binding globulin levels in oligospermic men with varicoceles. Fertil Steril 1996;66:299–304.

    PubMed  CAS  Google Scholar 

  20. Swerdloff RS, Walsh PC. Pituitary and gonadal hormones in patients with varicoceles. Fertil Steril 1975;26:1006–1012.

    PubMed  CAS  Google Scholar 

  21. Hudson RW, Crawford VA, McKay DE, et al. The gonadotropin response of men with varicoceles to a 4 hour infusion of gonadotropin-releasing hormone. Fertil Steril 1981;36:633–637.

    PubMed  CAS  Google Scholar 

  22. Hudson RW, Perez-Murrero RA, Crawford VA, et al. Hormonal parameters of men with varicoceles before and after varicocelectomy. Fertil Steril 1985;43:905–910.

    PubMed  CAS  Google Scholar 

  23. Segenreich E, Shnuley H, Singer R, et al. Andrological parameters in patients with varicoceles and fertility disorders treated by high ligation of the left spermatic vein. Int J Fertil 1986;31:200–203.

    PubMed  CAS  Google Scholar 

  24. Su L, Goldstein M, Schlegel PN. The effects of varicocelectomy on serum testosterone levels in infertile men with varicoceles. J Urol 1995;154:1752–1755.

    Article  PubMed  CAS  Google Scholar 

  25. Schreck R, Rieber P, Baeuerle PA. Reactive oxygen intermediates as apparently widely used messengers in the activation of NF-kappa β transcription factor and HIV-1. EMBO J 1991; 10:2247–2258.

    PubMed  CAS  Google Scholar 

  26. Sharma RK, Pasqualotto FF, Nelson DR. The reactive oxygen species-total antioxidant capacity (ROS-TAC) score is a new measure of oxidative stress to predict male infertility. Hum Reprod 1999;14:2801–2807.

    Article  PubMed  CAS  Google Scholar 

  27. Hendin BN, Kollettis PN, Sharma RK, et al. Varicocele is associated with elevated spermatozoal reactive oxygen species production and diminished seminal plasma antioxidant capacity. J Urol 1999;161:1831–1834.

    Article  PubMed  CAS  Google Scholar 

  28. Ahlberg NE, Bartley O, Chideckel N. Retrograde contrast filling of the left gonadal vein. ACTA Radid Diag 1965;3:385–392.

    Google Scholar 

  29. Fujisawa M, Yoshida S, Matsumoto O, et al. Decrease of topisomerase I activity in the testis of infertile men with varicocele. Arch Androl 1988;21:45–50.

    Article  PubMed  CAS  Google Scholar 

  30. Fujisawa M, Matsumoto O, Kamidono S, et al. Changes of enzymes involved in DNA synthesis in the testis of cryptorchid rats. J Reprod Fertil 1988;84:123–130.

    Article  PubMed  CAS  Google Scholar 

  31. Benoff S, Hurley IR, Barcia M, et al. A potential role for cadmium in the etiology of varicoceleassociated infertility. Fertil Steril 1997;67:336–347.

    Article  PubMed  CAS  Google Scholar 

  32. Cayan S, Lee D, Black LD, et al. Response to varicocelectomy in oligospermic men with and without defined genetic infertility. Urology 2001;57:530–535.

    Article  PubMed  CAS  Google Scholar 

  33. Fretz PC, Sandlow JI. Varicocele: Current concepts and pathophysiology, diagnosis and treatment. Urol Clin N Am 2002;29:921–937.

    Article  Google Scholar 

  34. Cayan S, Erdemir F, Ozbey I, et al. Can varicocelectomy significantly change the way couples use assisted reproductive technologies? J Urol 2002;167:1749–1756.

    Article  PubMed  Google Scholar 

  35. Pryor JL, Howards SS. Varicocele. Urol Clin North Am. 1987;14:499–513.

    PubMed  CAS  Google Scholar 

  36. Madgar I, Korasik A, Weissenberg R, et al. Controlled trial of high spermatic vein ligation for varicocele in infertile men. Fertil Steril 1995;63:120–124.

    PubMed  CAS  Google Scholar 

  37. Nieschlag E, Hertle L, Fischedick A, et al. Update on treatment of varicocele: counseling as effective as occlusion of the vena spermatica. Hum Reprod 1998;13:2147–2150.

    Article  PubMed  CAS  Google Scholar 

  38. Kamischke A, Nieschlag E. Varicocele treatment in the light of evidence-based andrology. Hum Reprod Update 2001;7:65–69.

    Article  PubMed  CAS  Google Scholar 

  39. Evers JLH, Collins JA. Assessment of efficacy of varicocele repair for male subfertility: a systematic review. Lancet 2003;361:1849–1852.

    Article  PubMed  Google Scholar 

  40. Schlegel PN. Is assisted reproduction the optimal treatment for varicocele-associated male infertility? A cost-effectiveness analysis. Urology 1997;49:83–90.

    Article  PubMed  CAS  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Urology, University of California San Francisco, San Francisco, CA

    Ulrike Zenke MD & Paul Turek MD

Authors
  1. Ulrike Zenke MD
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  2. Paul Turek MD
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Editor information

Editors and Affiliations

  1. Department of Obstetrics and Gynecology, Oregon Health and Science University, University Fertility Consultants, Portland, OR

    Phillip E. Patton MD  & David E. Battaglia PhD  & 

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© 2005 Humana Press Inc., Totowa, NJ

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Zenke, U., Turek, P. (2005). Varicocele and Infertility. In: Patton, P.E., Battaglia, D.E. (eds) Office Andrology. Contemporary Endocrinology. Humana Press. https://doi.org/10.1007/978-1-59259-876-2_10

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  • DOI: https://doi.org/10.1007/978-1-59259-876-2_10

  • Publisher Name: Humana Press

  • Print ISBN: 978-1-58829-318-3

  • Online ISBN: 978-1-59259-876-2

  • eBook Packages: MedicineMedicine (R0)

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