Largely undetected, varicoceles have been noted in 15% of all males. However, 40% of those men classified as subfertile have been diagnosed with varicoceles. It is important to note that subfertility relates to a delay in conceiving, while the term infertility is attached to cases where conceiving fails after attempting for at least one year.
What Is Varicoceles?
Varicoceles refers to the enlargement of the pampiniform plexus (veins) found within the scrotum. It is seen as a bulge just above the testicle. These localized veins cool the blood flow leading to the testicular artery. The veins have a valve to ensure the blood circulation flows in one direction only. If the valve fails, the return of the blood flow can cause swelling as the vein is then damaged. The swelling of the veins in the scrotum is labelled as a varicocele.
Varicoceles Causes and Symptoms
Varicocele causes can be as complex as the investigation into one’s infertility. In the case of varicoceles, studies have suggested that valve failure may be related due to the use of tobacco products as there is a higher risk of blood vessel damage in smokers. One study also found no correlation between the use of alcohol or the patient’s occupation and varicoceles.
That being said, to date, there has not been a case study determining the exact cause of why these blood vessel valves may fail and produce a varicocele.
Aside from the swelling bulge above the testicle, many males do not have obvious symptoms. Existing varicocele symptoms may be seen in a small percentage of patients who experience tenderness or a sense of heaviness at the site.
It should be noted any pain is rare, and if experienced, it may radiate from a dull sensation to a sharp pain. Patients experiencing pain have reported an intensity with physical exertion or when sitting or standing for long periods of time. These situations see an increase in the blood pooling as pressure is applied to the varicoceles. Any pain experienced often worsens over the day and is reduced when the patient lies down flat.
Also Read: Fertility and Vaping: The Impact E-Cigarettes Have on Men and Women
Diagnosis of Varicoceles for Infertility
The diagnosis of varicoceles for infertility concerns can be a massive undertaking for fertility clinics in Ontario. While many cases go unnoticed, varicoceles can affect the fertility of a male.
For successful conception, the health of sperm needs to be in good standing. The presence of a varicocele prevents the cooling of the blood, prohibiting the production of sperm as the testicle blood cannot be hot for the making of healthy sperm.
What does this mean for infertility cases? The diagnosis of varicoceles does not immediately lead to fertility issues, but it can be a leading risk factor for some men.
The quality and the quantity of sperm is vital to a man’s fertility. A varicocele not only damages otherwise healthy sperm, but it can also reduce sperm count. Through testing, varicoceles have been shown to increase the presence of deformed sperm and inhibit the movement of the possible viable sperm.
Aside from a physical exam that can expose a dilated vein in the scrotum or a smaller testicle, there are specialized tests to properly diagnose varicoceles. Fertility specialists often include tests for sperm count and a semen analysis with regular infertility diagnosis testing.
Also Read: Secondary Infertility in Men and Women: Causes and Treatment
Treatment of Varicoceles
It should be noted there are no topical creams, oral medications, or recommended lifestyle changes to treat or prevent varicoceles.
In the treatment of varicoceles, studies are inconclusive when it comes to the effect on one’s infertility or subfertility issues. Normally, any diagnosis of a varicocele is left untreated without accompanying symptoms such as pain.
For those facing infertility or painful symptoms, there are two varicocele treatment options. The right treatment for the patient is based on the doctor’s recommendation and the severity of the condition. The option can be surgery or a non-surgical treatment.
Non-Surgical Treatments
With a non-surgical treatment, an embolization can be performed. This outpatient procedure is commonly done in a doctor’s office with local anesthesia.
An embolization cuts off the blood supply to the varicocele reducing pressure. Closing the end of the veins forces the flow of blood to be redirected to other veins.
Surgical Treatment
Surgery to block blood flow to the varicocele is known as a varicocelectomy. The patient is under sedation with a general anesthetic. By inserting a laparoscope through the lower abdomen, the surgeon will be able to precisely cut the blood flow to the varicocele by clamping or using heat to cauterize the ends of the impacted vein.
Both procedures have been proven to be effective in the treatment of varicoceles. A study of patient groups undergoing both treatments found an embolization was favoured more in terms of the convenience of the procedure and the low recovery time.
Fertility specialists will monitor and test patients three to four months after treatment to see if new sperm developed. Patients may need to wait up to a year for sportive results from varicocele treatment.
In regard to either treatment helping with infertility, a case study has found that while some patients have had success in conceiving, the fertility rates in the majority of these patients remain low. The treatments were found to increase the sperm count of participants.
Male Infertility Treatment at ONE Fertility Kitchener Waterloo
The specialized infertility care at ONE Fertility Kitchener Waterloo is provided by a team of experienced specialists. Our evidence-based medical approach is customized to each individual’s needs.
As a leading fertility clinic in Kitchener-Waterloo, we understand the complexity of infertility and the underlying factors such as varicoceles. With compassion, grace, and advanced science, we are able to create a care plan with you! Contact us today to book a consultation with one of our esteemed fertility specialists.
