Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-848d4c4894-wg55d Total loading time: 0 Render date: 2024-05-21T02:24:42.241Z Has data issue: false hasContentIssue false

Chapter 15 - Varicocele Repair in the Era of IVF/ICSI

from Section 3 - Clinical Evaluation and Treatment of Male Infertility

Published online by Cambridge University Press:  06 December 2023

By
Jessica N. Schardein ,
Alexander W. Pastuszak  and
James M. Hotaling
Edited by
Douglas T. Carrell ,
Alexander W. Pastuszak  and
James M. Hotaling
Douglas T. Carrell
Affiliation:
Utah Center for Reproductive Medicine
Alexander W. Pastuszak
Affiliation:
University of Utah
James M. Hotaling
Affiliation:
Utah Center for Reproductive Medicine
Get access

Summary

Varicoceles are the most common correctable cause of male factor infertility. Varicocele repair, therefore, has an important role in the treatment of infertility. Performing varicocelectomy prior to assisted reproductive technology has the potential to improve male fertility and increase pregnancy and live birth rates. It can also be a cost-effective treatment method in infertile men with clinical varicoceles.

Keywords

varicocelectomyintrauterine insemination (IUI)in vitro fertilization (IVF)intracytoplasmic sperm injection (ICSI)assisted reproductive technology (ART)sperm retrieval ratespregnancy rateslive birth rates
Type
Chapter
Information
Men's Reproductive and Sexual Health Throughout the Lifespan
An Integrated Approach to Fertility, Sexual Function, and Vitality
 , pp. 120 - 126
Publisher: Cambridge University Press
Print publication year: 2023

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Irvine, DS. Epidemiology and aetiology of male infertility. Hum Reprod. 1998;13(Suppl. 1):33–44.CrossRefGoogle ScholarPubMed
Redmon, JB, Carey, P Pryor, JL. Varicocele: the most common cause of male factor infertility? Hum Reprod Update. 2002;8(1):53–58.Google Scholar
Kohn, TP, Kohn, JR, Pastuszak, AW. Varicocelectomy before assisted reproductive technology: are outcomes improved? Fertil Steril. 2017;108(3):385–391.Google Scholar
World Health Organization. The influence of varicocele on parameters of fertility in a large group of men presenting to infertility clinics. World Health Organization. Fertil Steril. 1992;57(6):1289–1293.Google Scholar
Pathak, P, Chandrashekar, A, Hakky, TS, et al. Varicocele management in the era of in vitro fertilization/intracytoplasmic sperm injection. Asian J Androl. 2016;18(3):343–348.Google Scholar
Goldstein, M, Eid, JF. Elevation of intratesticular and scrotal skin surface temperature in men with varicocele. J Urol. 1989;142(3):743–745.Google Scholar
Ozbek, E, Yurekli, M, Soylu, A, et al. The role of adrenomedullin in varicocele and impotence. BJU Int. 2000;86(6):694–698.Google Scholar
Hendin, BN, Kolettis, 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(6):1831–1834.Google Scholar
Gilbert, BR, Witkin, SS, Goldstein, M. Correlation of sperm-bound immunoglobulins with impaired semen analysis in infertile men with varicoceles. Fertil Steril. 1989;52(3):469–473.Google Scholar
Abdel-Meguid, TA, Farsi, HM, Al-Sayyad, A, et al. Effects of varicocele on serum testosterone and changes of testosterone after varicocelectomy: a prospective controlled study. Urology. 2014;84(5):1081–1087.Google Scholar
Mieusset, R, Bujan, L. Testicular heating and its possible contributions to male infertility: a review. Int J Androl. 1995;18(4):169–184.Google Scholar
Freire Gde, C. Surgery or embolization for varicoceles in subfertile men. Sao Paulo Med J. 2013;131(1):67.Google Scholar
Kroese, AC, de Lange, NM, Collins, J, et al. Surgery or embolization for varicoceles in subfertile men. Cochrane Database Syst Rev. 2012;10:CD000479.Google Scholar
Breznik, R, Vlaisavljevic, V, Borko, E. Treatment of varicocele and male fertility. Arch Androl. 1993;30(3):157–160.Google Scholar
Chen, SS, Chen, LK. Risk factors for progressive deterioration of semen quality in patients with varicocele. Urology. 2012;79(1):128–132.Google Scholar
Samplaski, MK, Lo, KC, Grober, ED, et al. Varicocelectomy to “upgrade” semen quality to allow couples to use less invasive forms of assisted reproductive technology. Fertil Steril. 2017;108(4):609–612.Google Scholar
Baazeem, A, Belzile, E, Ciampi, A, et al. Varicocele and male factor infertility treatment: a new meta-analysis and review of the role of varicocele repair. Eur Urol. 2011;60(4):796–808.Google Scholar
Zini, A, Azhar, R, Baazeem, A, et al. Effect of microsurgical varicocelectomy on human sperm chromatin and DNA integrity: a prospective trial. Int J Androl. 2011;34(1):14–19.Google Scholar
Smit, M, Romijn, JC, Wildhagen, MF, et al. Decreased sperm DNA fragmentation after surgical varicocelectomy is associated with increased pregnancy rate. J Urol. 2013;189(1 Suppl):S146–S150.CrossRefGoogle ScholarPubMed
Li, F, Yamaguchi, K, Okada, K, et al. Significant improvement of sperm DNA quality after microsurgical repair of varicocele. Syst Biol Reprod Med. 2012;58(5):274–277.Google Scholar
Wang, YJ, Zhang, RQ, Lin, YJ, et al. Relationship between varicocele and sperm DNA damage and the effect of varicocele repair: a meta-analysis. Reprod Biomed Online. 2012;25(3):307–314.Google Scholar
Chen, SS, Huang, WJ, Chang, LS, et al. Attenuation of oxidative stress after varicocelectomy in subfertile patients with varicocele. J Urol. 2008;179(2):639–642.CrossRefGoogle ScholarPubMed
Cayan, S, Erdemir, F, Ozbey, I, et al. Can varicocelectomy significantly change the way couples use assisted reproductive technologies? J Urol. 2002;167(4):1749–1752.Google Scholar
Turgut, H. The effect of varicocelectomy on the pregnancy rate in patients with severe oligospermia. Niger J Clin Pract. 2020;23(12):1744–1747.Google Scholar
Kamal, KM, Jarvi, K, Zini, A. Microsurgical varicocelectomy in the era of assisted reproductive technology: influence of initial semen quality on pregnancy rates. Fertil Steril. 2001;75(5):1013–1016.CrossRefGoogle ScholarPubMed
Grober, ED, Chan, PT, Zini, A, et al. Microsurgical treatment of persistent or recurrent varicocele. Fertil Steril. 2004;82(3):718–722.Google Scholar
Marmar, JL, Corson, SL, Batzer, FR, et al. Insemination data on men with varicoceles. Fertil Steril. 1992;57(5):1084–1090.Google Scholar
Daitch, JA, Bedaiwy, MA, Pasqualotto, EB, et al. Varicocelectomy improves intrauterine insemination success rates in men with varicocele. J Urol. 2001;165(5):1510–1513.CrossRefGoogle ScholarPubMed
Boman, JM, Libman, J, Zini, A. Microsurgical varicocelectomy for isolated asthenospermia. J Urol. 2008;180(5):2129–2132.Google Scholar
Kirby, EW, Wiener, LE, Rajanahally, S, et al. Undergoing varicocele repair before assisted reproduction improves pregnancy rate and live birth rate in azoospermic and oligospermic men with a varicocele: a systematic review and meta-analysis. Fertil Steril. 2016;106(6):1338–1343.CrossRefGoogle ScholarPubMed
Ashkenazi, J, Dicker, D, Feldberg, D, et al. The impact of spermatic vein ligation on the male factor in in vitro fertilization-embryo transfer and its relation to testosterone levels before and after operation. Fertil Steril. 1989;51(3):471–474.Google Scholar
Esteves, SC, Oliveira, FV, Bertolla, RP. Clinical outcome of intracytoplasmic sperm injection in infertile men with treated and untreated clinical varicocele. J Urol. 2010;184(4):1442–1446.Google Scholar
Gokce, A, Demirtas, A, Ozturk, A, et al. Association of left varicocoele with height, body mass index and sperm counts in infertile men. Andrology. 2013;1(1):116–119.Google Scholar
Pasqualotto, FF, Braga, DP, Figueira, RC, et al. Varicocelectomy does not impact pregnancy outcomes following intracytoplasmic sperm injection procedures. J Androl. 2012;33(2):239–243.Google Scholar
Kim, ED, Leibman, BB, Grinblat, DM, et al. Varicocele repair improves semen parameters in azoospermic men with spermatogenic failure. J Urol. 1999;162(3 Pt 1):737–740.Google Scholar
Matthews, GJ, Matthews, ED, Goldstein, M. Induction of spermatogenesis and achievement of pregnancy after microsurgical varicocelectomy in men with azoospermia and severe oligoasthenospermia. Fertil Steril. 1998;70(1):71–75.Google Scholar
Schoysman, R, Vanderzwalmen, P, Nijs, M, et al. Pregnancy after fertilisation with human testicular spermatozoa. Lancet. 1993;342(8881):1237.CrossRefGoogle ScholarPubMed
Schlegel, PN. Testicular sperm extraction: microdissection improves sperm yield with minimal tissue excision. Hum Reprod. 1999;14(1):131–135.Google Scholar
Zampieri, N, Bosaro, L, Costantini, C, et al. Relationship between testicular sperm extraction and varicocelectomy in patients with varicocele and nonobstructive azoospermia. Urology. 2013;82(1):74–77.Google Scholar
Dubin, JM, Greer, AB, Kohn, TP, et al. Men with severe oligospermia appear to benefit from varicocele repair: a cost-effectiveness analysis of assisted reproductive technology. Urology. 2018;111:99–103.CrossRefGoogle ScholarPubMed
Esteves, SC, Miyaoka, R, Roque, M, et al. Outcome of varicocele repair in men with nonobstructive azoospermia: systematic review and meta-analysis. Asian J Androl. 2016;18(2):246–253.Google Scholar
Inci, K, Hascicek, M, Kara, O, et al. Sperm retrieval and intracytoplasmic sperm injection in men with nonobstructive azoospermia, and treated and untreated varicocele. J Urol. 2009. 182(4):1500–1505.Google Scholar
Haydardedeoglu, B, Turunc, T, Kilicdag, EB, et al. The effect of prior varicocelectomy in patients with nonobstructive azoospermia on intracytoplasmic sperm injection outcomes: a retrospective pilot study. Urology. 2010;75(1):83–86.Google Scholar
Salonia, A, Bettocchi, C, Boeri, L, et al. European Association of Urology Guidelines on Sexual and Reproductive Health – 2021 update: male sexual dysfunction. Eur Urol. 2021;80(3):333–357.Google Scholar
Schlegel, PN, Sigman, M, Collura, B, et al. Diagnosis and treatment of infertility in men: AUA/ASRM guideline part II. Fertil Steril. 2021;115(1):62–69.Google Scholar
Kohn, TP, Ohlander, SJ, Jacob, JS, et al. The effect of subclinical varicocele on pregnancy rates and semen parameters: a systematic review and meta-analysis. Curr Urol Rep. 2018;19(7):53.CrossRefGoogle ScholarPubMed
Al Bakri, A, Lo, K, Grober, E, et al. Time for improvement in semen parameters after varicocelectomy. J Urol. 2012;187(1):227–231.Google Scholar
Abdel-Meguid, TA. Predictors of sperm recovery and azoospermia relapse in men with nonobstructive azoospermia after varicocele repair. J Urol. 2012;187(1):222–226.Google Scholar
Meng, MV, Greene, KL, Turek, PJ. Surgery or assisted reproduction? A decision analysis of treatment costs in male infertility. J Urol. 2005;174(5):1926–1931; discussion 1931.Google Scholar
Lee, R, Li, PS, Goldstein, M, et al. A decision analysis of treatments for nonobstructive azoospermia associated with varicocele. Fertil Steril. 2009;92(1):188–196.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×