Any man that has low sperm counts or poor sperm movement could have a problem
known as a varicocele.
Learn about varicocele on today's episode of InfertilityTV
A varicocele is the presence of enlarged or dilated veins
in the blood vessels of the scrotum
Normally, the scrotal veins have valves
that regulate the blood flow
However, in some cases the valves are absent or
defective and the blood does not circulate out of the testicles efficiently.
This results in swelling of the veins above and behind the testicles
About 85% of varicoceles develop in the left testicle
Do varicoceles cause infertility in men?
The answer is...sometimes!
Let me explain.
We know that if you examine men with perfectly normal fertility
you will find that about 20% of them have a varicocele
But...
if you look at men who have infertility
meaning he and his partner they're not able to
conceive for about a year
then you will find a varicocele in about 40% of that group
So varicoceles are associated with a greater likelihood of infertility
But, not all varicoceles will result in infertility
at the present time, there is no way to determine
whether a varicocele in a specific individual
is the cause of his infertility problems
We are not entirely certain how varicoceles cause infertility
Some evidence points to the increased temperature of the blood
raising the temperature of the testicles
which then damages the sperm
Heat can damage or destroy sperm
The increased temperature may also
impede production of new healthy sperm
Another theory is that in men with varicoceles
the testicular fluid which carries sperm
has an increased
concentration of chemicals which can damage sperm.
These chemicals are called
reactive oxygen species
or ROS.
So how do you know if you have a varicocele?
The most obvious cases can be seen by just looking
at a guy's scrotum.
Large varicoceles
can look or feel like a bag of worms
It is easier to see or feel
a varicocele when a man is standing compared to one he is lying down
Sometimes a varicocele may become
more apparent when a man bears down
to try to increase the intra-abdominal pressure
The American Urological Association
states that only varicoceles that can be
felt have been documented to be
associated with infertility
Not everyone agrees with that position, however.
Ultrasound of the scrotum can be used to
diagnose a smaller less obvious varicocele.
Some advanced types of ultrasound can even measure blood flow
in the veins of the scrotum.
So let's say you have infertility
and you have been diagnosed with a varicocele...
What can you do?
First
remember you might not have to do anything
Just because you have a
varicocele doesn't mean it is the cause for your infertility.
But if you do and
your doctor really believe your varicocele is causing a problem there
are a number of ways to try to get rid of it
The veins can be surgically removed or tied off
There is a method called embolization that avoids surgery
by injecting tiny particles in the veins and causing a blockage
that ends the abnormal blood flow
This is done with x-ray guidance
Finally, another alternative
instead of improving the sperm numbers
is to try to make better
use of a sperm that a guy does have
If his problem is mild an IUI or
intrauterine insemination can increase the number of sperm
that make it into the fallopian tubes where fertilization happens.
For guys with more severe sperm problems
IVF is a very effective treatment
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