Should a Varicocele Be Repaired Before Assisted Reproductive Technology Treatment?

  • Eric Chung


The presence of varicocele is the most common correctable factor for male infertility. There is strong evidence to support surgical repair of clinical varicocele to improve semen parameters, decrease seminal oxidative stress and sperm DNA fragmentation, and increase the chance of natural conception. Microscopic varicocelectomy is accepted as the standard of care with higher clinical outcomes and least complication rate. However, it is unclear whether performing varicocelectomy in men with clinical varicocele prior to assisted reproductive technology improves treatment outcome or is more “cost-effective” than just proceeding with assisted reproduction. The following chapter evaluates the clinical evidence pertaining to varicocele in semen parameters (including sperm retrieval rate), the pregnancy rate in natural conception vs. assisted reproduction, and cost analysis of varicocele surgery in the setting of couples who are undergoing assisted reproductive technology treatment.


Varicocele Azoospermia Oligospermia MicroTESE Cost-effectiveness Successful pregnancy Assisted reproductive technology 


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Eric Chung
    • 1
  1. 1.AndroUrology CentreSpring HillAustralia

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