Skip to main content
SpringerLink
Log in

Grade 1 Varicocele and Borderline/Normal Conventional Semen Analysis

  • Chapter
  • First Online:
Varicocele and Male Infertility

  • 651 Accesses

Abstract

The condition known as varicocele has been described for centuries. Literature defines varicocele as a cause of infertility for 50% of cases of male component. Today, there is a discrete agreement regarding the need for intervention in case of high-grade varicocele with marked seminal alterations while the management of low-grade varicocele with modest changes in the sperm is still debated. The main problem is therefore to define what to do when we are facing a patient who has a modest alteration of the semen analysis.

In this chapter, we focus on the diagnostic methods for varicocele and the clinical management of patients with grade 1 varicocele and borderline/normal conventional semen analysis. We performed a literature review and integrated it with our personal experience.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 129.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Dubin L, Amelar RD. Etiologic factors in 1294 consecutive cases of male infertility. Fertil Steril. 1971;22(8):469–74.

    Article  CAS  PubMed  Google Scholar 

  2. Kantartzi PD, Goulis CD, Goulis GD, Papadimas I. Male infertility and varicocele: myths and reality. Hippokratia. 2007;11(3):99–104.

    CAS  PubMed  PubMed Central  Google Scholar 

  3. Barwell R. One hundred cases of varicocele treated by the subcutaneous wire loop. Lancet. 1885;i:978–80.

    Article  Google Scholar 

  4. Bennet WH. Varicocele, particularly with reference to its radical cure. Lancet. 1889;i:261–3.

    Google Scholar 

  5. Damsgaard J, Joensen UN, Carlsen E, Erenpreiss J, Blomberg Jensen M, Matulevicius V, Zilaitiene B, Olesen IA, Perheentupa A, Punab M, Salzbrunn A, Toppari J, Virtanen HE, Juul A, Skakkebæk NE, Jørgensen N. Varicocele is associated with impaired semen quality and reproductive hormone levels: a study of 7035 Healthy Young Men from Six European Countries. Eur Urol. 2016;70(6):1019–29. https://doi.org/10.1016/j.eururo.2016.06.044. Epub 2016 Jul 14.

    Article  CAS  PubMed  Google Scholar 

  6. Koji C, Ramasamy R, Lamb Dolores J, Lipshultz Larry I. The varicocele: diagnostic dilemmas, therapeutic challenges and future perspectives. Asian J Androl. 2016;18(2):276–81.

    Article  Google Scholar 

  7. Mohammad Alserhan MD, Abdullah Rababaah MD, Ahmad Alhiari MD, Laith Khasawneh MD, Mohammad Abd-Aldayem MD. The role of varicocele grade on seminal fluid parameters post Varicocelectomy: experience at Prince Hussein urology Centre. J Royal Med Ser. 2016;23(3).

    Article  Google Scholar 

  8. Dubin L, Amelar RD. Varicocele size and results of varicocelectomy in selected subfertile men with varicocele. Fertil Steril. 1970;21(8):606–9.

    Article  CAS  PubMed  Google Scholar 

  9. Hirsh AV, Cameron KM, Tyler JP, Simpson J, Pryor JP. The Doppler assessment of varicoceles and internal spermatic vein reflux in infertile men. Br J Urol. 1980;52(1):50–6.

    Article  CAS  PubMed  Google Scholar 

  10. Grasso M, Lania C, Castelli M, Galli L, Rigatti P. Bilateral varicocele: impact of right spermatic vein ligation on fertility. J Urol. 1995;153(6):1847–8.

    Article  CAS  PubMed  Google Scholar 

  11. Miyaoka R, Sandro C. Esteves a critical appraisal on the role of Varicocele in male infertility. Adv Urol. 2012:597495. 9 pages.

    Google Scholar 

  12. Kurtz MP, Zurakowski D, Rosoklija I, Bauer SB, Borer JG, Johnson KL, Migliozzi M, Diamond DA. Semen parameters in adolescents with varicocele: association with testis volume differential and total testis volume. J Urol. 2015;193(5 Suppl):1843–7.

    Article  PubMed  Google Scholar 

  13. Kwon CS, Lee JH. Is semen analysis necessary for varicocele patients in their early 20s? World J Mens Health. 2014;32(1):50–5.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Mori MM, Bertolla RP, Fraietta R, Ortiz V, Cedenho AP. Does varicocele grade determine extent of alteration to spermatogenesis in adolescents? Fertil Steril. 2008;90(5):1769–73.

    Article  PubMed  Google Scholar 

  15. Foppiani L, Cavani S, Piredda S, Perroni L, Fazzuoli L, Giusti M. Lack of evidence of a genetic origin in the impaired spermatogenesis of a patient cohort with low-grade varicocele. Endocrinol Invest. 2001;24(4):217–23.

    Article  CAS  Google Scholar 

  16. Pontonnier F, Mansat A, Mieusset R, Malonga G, Gautier JR, Ioualalen A. Varicocelectomy for infertility is more effective in cases of sperm count less than 5 million/ml. Apropos of 70 cases. Ann Urol (Paris). 1986;20(4):249–51.

    CAS  Google Scholar 

  17. Jonathan PJ. Effects of varicocele on male fertility. Hum Reprod Update. 2001;7(1):59±64.

    Google Scholar 

  18. Kohn TP, Ohlander SJ, Jacob JS, Griffin TM, Lipshultz LI, Pastuszak AW. The effect of subclinical varicocele on pregnancy rates and semen parameters: a systematic review and meta-analysis. Curr Urol Rep. 2018;19(7):53.

    Article  PubMed  Google Scholar 

  19. Soleimani MZ, Jalali Mashayekhi F, Mousavi Hasanzade M, Baazm M. Alteration in CatSper1 and 2 genes expression, sperm parameters and testis histology in varicocelized rats. Int J Reprod Biomed (Yazd). 2018;16(3):183–90.

    Article  CAS  Google Scholar 

  20. Verhovsky G, Neheman A, Rappaport YH, Kedem R, Hofman A, Zisman A, Haifler M. Varicocele management strategies and resulting paternity rates in a cohort of young adults. Urology. 2018:S0090–4295(18)30389–3.

    Google Scholar 

  21. WHO laboratory manual for the examination and processing of human semen. 5th ed: World Health Organisation.

    Google Scholar 

  22. Levitas E, Lunenfeld E, Weisz N, Friger M, Potashnik G. Relationship between age and semen parameters in men with normal sperm concentration: analysis of 6022 semen samples. Andrologia. 2007;39(2):45–50.

    Article  CAS  PubMed  Google Scholar 

  23. Zini A, Azhar R, Baazeem A, Gabriel MS. Effect of microsurgical varicocelectomy on human sperm chromatin and DNA integrity: a prospective trial. Int J Androl. 2011;34:14–9.

    Article  CAS  PubMed  Google Scholar 

  24. Abdel-Meguid TA, Al-Sayyad A, Tayib A, Farsi HM. Does varicocele repair improve male infertility? An evidence-based perspective from a randomized, controlled trial. Eur Urol. 2011;59:455–61.

    Article  PubMed  Google Scholar 

  25. Steckel J, Dicker AP, Goldstein M. Relationship between varicoceles size and response to varicocelectomy. J Urol. 1993;149:769–71.

    Article  CAS  PubMed  Google Scholar 

  26. Braedel HU, Steffens J, Ziegler M, Polsky MS, Platt ML. Possible ontogenetic etiology for idiopathic left varicocele. J Urol. 1994;151:62–6.

    Article  CAS  PubMed  Google Scholar 

  27. Sigman M, Jarow JP. Ipsilateral testicular hypotrophy is associated with decreased sperm counts in infertile men with varicoceles. J Urol. 1997;158(2):605.

    Article  CAS  PubMed  Google Scholar 

  28. Grasso M, Lania C, Blanco S, Confalonieri S, Grasso AAC. Efficacy of spermatic vein ligation in patients affected by high grade left varicocele. Int Braz J Urol. 2014;40(1):62–6.

    Article  PubMed  Google Scholar 

  29. Grasso M, Lania C, Castelli M, Galli L, Franzoso F, Rigatti P. Low-grade left varicocele in patients over 30 years old: the effect of spermatic vein ligation on fertility. BJU Int. 2000;85(3):305–7.

    Article  CAS  PubMed  Google Scholar 

  30. Çayan S, Bozlu M, Akbay E. Update on the novel management and future paternity situation in adolescents with varicocele. Turk J Urol. 2017;43(3):241–6.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Bogaert G, Orye C, De Win G. Pubertal screening and treatment for varicocele do not improve chance of paternity as adult. J Urol. 2013;189(6):2298–303.

    Article  PubMed  Google Scholar 

  32. Agarwal A, et al. Efficacy of varicocelectomy in improving semen parameters: new meta-analytical approach. Urology. 2007;70:532.

    Article  PubMed  Google Scholar 

  33. Zini A, et al. Are varicoceles associated with increased deoxyribonucleic acid fragmentation? Fertil Steril. 2011;96:1283.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Urology, ASST MONZA, Ospedale San Gerardo, Monza, Italy

    Marco Grasso

  2. Department of Urology, IRCCS Ospedale San Raffaele, Milan, Italy

    Caterina Lania

  3. Department of Surgery, Division of Urology, Ospedale Beata Vergine-Ente Ospedaliero Cantonale, Mendrisio, Ticino, Switzerland

    Angelica Anna Chiara Grasso

Authors
  1. Marco Grasso
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Caterina Lania
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Angelica Anna Chiara Grasso
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. ANDROFERT, Andrology & Human Reproduction Clinic, Campinas, São Paulo, Brazil

    Sandro C Esteves

  2. S.H. Ho Urology Centre, Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, Hong Kong

    Chak-Lam Cho

  3. Department of Urology, Hamad Medical Corporation, Weill Cornell Medicine Qatar, Doha, Qatar

    Ahmad Majzoub

  4. Department of Urology, Cleveland Clinic, Cleveland, OH, USA

    Ashok Agarwal

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Grasso, M., Lania, C., Grasso, A.A.C. (2019). Grade 1 Varicocele and Borderline/Normal Conventional Semen Analysis. In: Esteves, S., Cho, CL., Majzoub, A., Agarwal, A. (eds) Varicocele and Male Infertility. Springer, Cham. https://doi.org/10.1007/978-3-319-79102-9_48

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-79102-9_48

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-79101-2

  • Online ISBN: 978-3-319-79102-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation