Varicose veins of the scrotum are considered a common pathology of the male reproductive system. This seemingly harmless disease is fraught with unpleasant consequences, in particular, decreased fertility. Infertility with varicocele occurs in approximately 25% of men and is often main reason problems with conceiving in married couples.

Causes of infertility with varicocele

Male fertility directly depends on the quality of sperm. The main repository of sperm is the testicles, and in order to produce germ cells, it is necessary that the processes of thermoregulation, oxygen saturation and blood supply are maintained at the proper level.

With unilateral and bilateral varicocele, blood microcirculation in the vessels of the scrotum worsens, cell hypoxia occurs, and tissue temperature rises.

It leads to various deviations at work genitourinary system, for example, problems with urination and inflammation of the prostate, as well as deterioration of spermatogenesis and, as a result, partial or complete infertility.

Can infertility with varicocele be treated?

As practice shows, in most cases, infertility resulting from testicular varicose veins is curable. During therapy, attention is paid not so much to reproductive dysfunction, but vascular pathology. With proper timely treatment of varicocele, fertility is gradually restored on its own.

Varicose veins of the scrotum are eliminated surgically or using conservative therapy: taking medications, performing special exercises, massage, application of products traditional medicine(infusions for internal use, compresses).

Men suffering from grade 1 and 2 varicocele have a greater chance of normalizing reproductive function. Stage 3 and 4 disease is much more difficult to cure, and often in patients with running form pathology, fertility cannot be restored even after appropriate treatment.

Is it possible to get pregnant with varicocele?

Although varicocele has a direct impact on the ability to have children, the occurrence of this pathology does not yet indicate that a man will not be able to conceive a child. In some representatives of the stronger sex, changes in sperm quality due to testicular varicose veins are minimal and only slightly reduce the chances of fertilization. More often, this situation is observed in those who suffer from the initial stage of varicocele and were highly fertile before the disease.

However, what longer man If the patient delays treatment of testicular vascular pathology, the quality of sperm becomes worse: sperm lose activity and are produced in insufficient quantities for conception.

Varicocele is a common disease that mainly affects young men and boys under 18 years of age. The disease is characterized by dilation of the veins of the spermatic cord, congestion and the formation of nodes.

The seriousness of the disease lies in the fact that varicocele and infertility are related to each other.

Features and causes of the disease

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When there is dilation of the veins in zone of the plexus of the spermatic cord, varicocele begins to develop and, as a result, infertility.

If the blood supply is insufficient, pathological processes begin to occur.

There is a dysfunction of spermatogenesis. Ultimately, infertility occurs.

Causes that lead to the disease:

• weak walls of venous vessels;
• impaired blood supply to the testicles at the capillary level;
• pressure in the vessels increases;
• stagnation of venous blood.

For your information! You can read what a varicocele looks like in an earlier article.

What causes problems?

Statistics say that Men who are actively involved in sports are most susceptible to this pathology. and those experiencing physical stress. As the disease progresses, the patient begins to experience discomfort and painful sensations in the scrotum area.

The development of the disease is accompanied by:

• unaesthetic appearance of the scrotum, the dilated veins of which are determined not only by palpation, but also visually;
• deterioration in sperm quality.

All these factors without appropriate competent treatment can lead to irreversible processes and infertility.

How does pathology develop and appear?

The pathogenesis of the disease is presented in the photo.

Main symptoms of the disease:

• nagging pain in the testicle area;
• feeling of heaviness in the groin;
• discomfort in the scrotum during physical activity;
• discomfort.

1st degree

There are no external manifestations of varicocele visible to the eye. The disease is also not determined by palpation. The diagnosis can only be made based on the results of an ultrasound scan.

2nd degree

Visually, the expansion of veins is noticeable when vertical position bodies. The altered veins can be easily felt by palpation. With a horizontal position of the body, symptoms are not noticeable, spermatogenesis worsens.

3rd degree

The symptoms are clear. Pathological changes are noticeable and palpable in any position of the body.

4th degree

All signs of varicocele are present. Dilated vessels are noticeable and hang in clusters. Testicular dysfunction is noted.

Is there a relationship with the development of infertility?

To understand whether the diagnosis of varicocele affects male infertility, it is necessary to consider the relationship between these conditions.

Deterioration of the circulatory system in the testicles reduces mobility sperm and affects their number.

At the same time, the quality of sperm decreases so much that infertility can occur.

Enlarged veins lead to disturbances in the immune system. The inflammatory process that develops against this background directly affects the reduction in the ability of the male body to fertilize.

Not in all cases the disease leads to infertility; there is a possibility that the ability to conceive will be preserved. There are also situations in which varicocele and infertility in men are not related to each other, but are caused by other reasons.

For your information! Whether varicocele disease affects conception is determined on a case-by-case basis.

Methods for diagnosing the disease

In order to diagnose the disease, various studies are used:

1. Palpation, which is carried out by a doctor and allows you to identify the dilation of the vessels of the spermatic cord.
2. Hormone analysis. This method always gives a clear picture of the connection between pathological processes in blood vessels and infertility.
3. Spermogram– a study to determine the quality of sperm produced.
4. Ultrasound– an informative way to obtain data on the condition of the testicles.

Treatment: indications and main types of operations

The most effective method Treatment for varicocele is considered to be surgery.

Surgical intervention is prescribed according to indications:

• diagnosed infertility;
• visual defect;
• atrophic processes in the testicles;
• pain in the groin.

Classical techniques

Excision of the damaged area of ​​venous blood flow occurs during surgical operations that can help normalize blood flow.

These methods differ in the location of the incision and its length. A timely operation increases the chance of successfully conceiving a child.

Among the commonly used methods are the following varicocelectomy operations:

1. According to Ivanissevich.
2. Marmar method.
3. Operation Palomo.

For your information! You can read more about operations for varicocele in the articles on the website.

Other types of surgical interventions

In addition to classical surgery, doctors use endoscopy using modern technology to cure the disease.

Laparoscopy involves small incisions(less than 20 mm) and monitoring the surgical process using a camera by an experienced doctor.

A quick result is obtained by replacing a diseased vein with a healthy one.

In other techniques, the result does not appear so quickly.

Sclerotherapy – performed by injection into a vein special means to seal the vessel and remove it from the circulatory system. With this method, no incisions are made, since the medication is administered through the scrotum.

Predictions of treatment effectiveness

The effectiveness of the operation is influenced by various circumstances. Has the meaning general state sick, individual characteristics organism and the degree of neglect of the disease. Reviews about the effectiveness of the surgical method are mostly positive - the symptoms go away, the man begins to feel better.

The quality of sperm in men with the first and second degrees of the disease is restored in 75 percent. But the ability to cause pregnancy in later stages is restored to a lesser extent - only in 4 out of 10 people.

For your information! Normalization of fertility and significant improvement in sperm counts do not occur immediately after surgery.

Spermogram indicators

Viable spermatozoa with varicocele are no more than a quarter. The likelihood of conceiving in such a patient is reduced. Despite the production of sperm, the sperm are not able to fertilize the egg and pregnancy does not occur.

After surgery and a recovery period, which lasts from six months to a year, spermogram indicators are gradually restored. To track dynamics, analysis is performed regularly.

Important! For full recovery it is necessary to have regular sex life.

How to improve sperm quality without drugs

To means of prevention to maintain men's health, include regular medical examinations.

If necessary, undergo an ultrasound scan. To prevent blood from stagnating in the pelvic organs, it is necessary to dose physical activity.

If you are at risk of developing varicocele:

• alcohol should be excluded;
• sports activities are kept to a minimum;
• it is necessary to normalize intestinal function;
• have regular sex life;
• do not wear tight underwear.

Stages of testicular dysfunction

Testicular dysfunction occurs gradually.

The following stages are distinguished:

1. Compensatory. At this stage, sperm retains its quality, and sperm retains its motility.
2. The sperm count remains normal, but their motility decreases.
3. All spermogram indicators decrease, testicular atrophy develops.

Varicocele and IVF

Varicocele does not apply to dangerous diseases, and is not life-threatening. A man can live without surgery.

Varicocele and infertility are closely related. About 20% of men under the age of 35 face a similar diagnosis, and almost 40% of men with this pathology cannot have children. For many, the occurrence of such a problem can cause a significant deterioration in sperm quality, which can lead to secondary infertility. Fortunately, methods modern medicine in most cases allows men to conceive and have children at the same time. Correct and timely treatment helps to achieve relative improvement, stabilization and a positive outcome of the disease.

Varicocele is an expansion of the vessels of the venous plexus of the spermatic cord. This network is one of the important elements of the male spermatic cord itself and is located inside the inguinal canal. After leaving the canal, the network of small veins merges into the testicular vein. Thus, varicocele turns out to be significant influence on the functioning of the male gonads - testicles.

Men who are engaged in heavy work are most susceptible to the development of pathology. physical labor or professional sports. In most cases, the disease does not manifest itself, and the person does not even suspect any disorders in his body, and in the meantime he may already develop infertility. However, when sharp increase degree of load, severe pain appears in the groin area, and the disease becomes active.

The main causes of varicocele:

• weak walls of the venous vessels of the spermatic cord;
• compression causing a significant increase in pressure in the veins;
• interference with the outflow of venous blood;
• disturbances of capillary circulation in the testicles and other male reproductive glands.

The negative impact of such reasons not only causes a deterioration in the appearance of the scrotum, but also reduces the quality and quantity of seminal fluid produced in the testicles. Thus, such a pathological condition can cause secondary infertility in men.

Stages of varicocele

Andrologists who deal with the problems of male infertility identify several main stages of the disease.

1. The first stage is latent. In the initial stages, the disease does not manifest itself in any way. Appearance the scrotum remains without visible changes, the patient is not disturbed painful sensations during ejaculation. A slight increase in the diameter of the veins of the plexus of the spermatic cord can only be registered when ultrasound examination groin area.
2. The second stage - the symptoms of the disease still do not bother the man, but in a standing position the venous plexus can be seen and palpated. Filled veins expand and protrude. Infertility does not yet develop.
3. The third stage - protruding veins greatly change the external genitalia; the reasons for such changes do not yet cause serious disturbances in reproductive function, but they already cause significant anxiety and pain to the patient.
4. Stage four – bright severe symptoms: pain in the groin area, venous dilations are visible to the naked eye, the doctor no longer needs to conduct a palpation examination. At this stage, a man has problems conceiving, as there is a disruption in the production of seminal fluid.

How does it manifest itself?

The largest number of cases of the disease is registered in middle-aged men, less often in teenage boys. Symptoms of varicocele in adolescents and adults are no different.

1. Drawing, dull pain in the groin, occurring predominantly on the left side.
2. Painful and unpleasant sensations intensify with heavy physical exertion or professional pursuits sports.
3. A constant feeling of discomfort that does not decrease even at rest.
4. Feeling of heaviness in the lower abdomen.
5. Problems with urination.
6. The patient cannot describe the location of the pain.

Depending on the degree and symptoms of varicocele in adolescent and adult men may differ. On early stages there are no major changes from blood vessels and testicular function, however, as the disease progresses, the symptoms become more pronounced.

Varicose veins with varicocele are similar to varicose veins lower limbs and can seriously affect physical health men, cause the development of self-doubt and the development of a number of complexes. Most serious consequences The disease occurs in young patients when the ability to conceive a child is lost.

Diagnostics

In order to reliably determine the presence of a pathological condition in a patient, the doctor must conduct comprehensive examination genital area. Diagnostic methods include:

• palpation;
• ultrasonography;
• spermogram;
• tests for male sex hormones.

These clinical examination methods make it possible to reliably verify the development of varicose veins in the area of ​​the inguinal canal and scrotum. Even in the initial stages of the disease, when the venous network cannot be palpated, the doctor can make a diagnosis based on the results of an ultrasound examination.

Carrying out a spermogram and blood tests for testicular hormones allows you to accurately determine the degree of dysfunction of the testicles and impaired spermatogenesis, and establish male infertility. Timely diagnosis and treatment of varicocele can achieve positive dynamics in relatively short time and avoid unpleasant consequences for men in the form of infertility and erectile dysfunction.

Does varicocele affect conception?

Not in every case, varicocele negatively affects a man’s reproductive function. Not every man who has been given a similar diagnosis, the pathology reaches stages 3-4, at which disturbances in spermatogenesis and normal erection occur.

The disease in its final stages is the cause of infertility, which probably cannot be cured using conservative methods. Surgical treatment can increase the chances of a wife becoming pregnant, but even in this case, conception does not always occur after surgery.

How does a varicocele affect sperm?

There is not always a connection between varicocele and infertility in men, just as fertility is not always evidence of varicose veins of the venous plexus of the spermatic cord. Often patients live with a similar pathology and have 2-3 healthy children.

In most cases, due to an increase in local temperature, sperm storage conditions are violated, which leads to:

• decreased quality of seminal fluid;
• sperm count;
• capable of fertilizing an egg decreases.

Reproductive function disorders are preceded by the main symptoms of the disease, upon detection of which it is necessary to begin immediate treatment. However, often men do not attach serious importance to such manifestations, the disease continues to develop, and the presence of frequent or constant heavy physical activity further provokes a worsening of the pathological condition and the development of infertility.

As a consequence of such neglect of one’s own health, the quality of sperm, the number of viable, healthy germ cells decreases, and the ability to conceive in a sick man decreases sharply.

Why does infertility develop with varicocele?

In case of male infertility due to varicocele, not only violations of correct and complete spermatogenesis occur, but also an inflammatory process develops in the scrotum, which is the main cause of serious reproductive dysfunction, including the inability to conceive healthy child.

Increasing the storage temperature of seminal fluid, activation immune system organism, which perceives germ cells as foreign agents, leads to infertility. Even surgery and a course of rehabilitation treatment do not guarantee complete recovery and restoration of a man’s reproductive function after varicocele.

Treatment

When the doctor determines whether varicocele affects infertility in a particular patient or not, he makes a decision on treatment tactics, which he discusses with the man before starting therapy. In most cases, to eliminate the pathology, a surgical method is used in which venous dilations are removed. After the operation, sperm storage conditions become relatively better, and subsequent diagnosis and conservative treatment enhance positive dynamics after surgery.

Is it worth agreeing to the operation?

Currently, surgical intervention is the most productive and effective method treatment of varicocele and infertility associated with this pathology. None medications, physiotherapy, traditional medicine recipes and other therapeutic methods do not bring the visible improvement that the patient needs. However, even so effective technique treatment may not always be a solution to the problem.

The results of the operation directly depend on the health status, age of the patient and stage of the disease. IN Lately Various dietary supplements have appeared on the market, the action of which is aimed at restoring varicose veins, including varicocele. Even a large number of positive feedback does not confirm a positive clinical effect. Consultation with a doctor is required! Children should not take this medication!

What types of surgery are there?

There are several surgical techniques for treating varicocele.

1. Classic method. Includes several types of surgery. All 3 techniques involve clamping the veins at both ends and excising them.
2. Endoscopic method. Along with classical varicocelectomy, there is a relatively safe, minimally invasive method, which is carried out using thin tubes and clamps through inconspicuous incisions in the integumentary tissue. Otherwise, this type of operation differs little from the classic one.
3. Sclerotherapy is used when the disease has progressed significantly, causing certain complications in the patient's condition. This method does not require dissection of the integumentary tissue of the scrotum. The doctor administers a course of injections of a special drug into the vein of the testicle, which induces an adhesive process. Thanks to adhesive, an improvement in the condition is achieved reproductive system men.
4. The method of testicular revascularization consists of two stages: excision of enlarged sections of the venous plexus, and then replacing them with healthy or artificial vessels. home positive trait this method- relatively quick result treatment. Improvement in the condition is observed within 2-4 days.

Postoperative period

Right after surgical treatment The patient and his wife have a question: “Is it possible to get pregnant after surgery and after how long?” Doctors most often cannot specifically answer this question, since the result of treatment depends on a number of factors:

• age;
• patient's health status;
• stage of disease development;
• presence of complications before and after surgery;
• other problems of the reproductive system.

Varicocele is not always the only cause of male infertility - there are often cases when pathological expansion of the venous plexus of the spermatic cord was concomitant disease, which only aggravated the disturbances of male reproductive function.

Rehabilitation

Depending on the type of carried out surgery recovery times will vary significantly. With minimally invasive and non-invasive treatment methods, the recovery process does not exceed 7-9 days, however, even after the expiration of the period, there is no need to rush to return to full-fledged sexual relations. Any interference with the integrity of the body requires certain period to restore functions and stabilize the body.

FAQ

Is it possible to have children with varicocele without surgery?

Even if it is impossible to conceive a child naturally, there are many various options, which help a couple become pregnant and give birth to a healthy child. Varicocele is not always the cause of a serious disorder in a man’s reproductive function, such as infertility.

In case of unsuccessful operation

Even if surgery does not bring the expected result, there is still a chance of having children after surgery. The couple can choose one of alternative ways conceiving a child.

An alternative method of fertilization for varicocele

Pregnancy after varicocele may not occur if natural conception even with successful treatment of the pathology. Due to the disease, spermatogenesis disorders occur, which disappear only after 6-8 months after surgery. However, treatment is not always effective. In this case, the couple needs to pay attention to alternative methods fertilization:

• injection of sperm directly into a woman’s egg;
• transfer of the most motile sperm into the fallopian tubes;
• surrogacy and the use of donor sperm.

The latter method can be used in case of infertility of both partners.

Varicocele is one of the most discussed problems in the field of urology, as it occurs quite often. This type of varicose veins leads to elongation and tortuosity of 4 to 5 vessels of the spermatic cord. The disease makes itself felt most often in the prime of youth, between the ages of 17 and 30. The slow development of varicose veins, which may go unnoticed, leads to additional and significant health problems. Awareness and ability to recognize the disease will help to accept preventive measures

and coordinate treatment methods.

How does varicocele manifest itself? In most cases, the disease occurs without any external manifestations or unpleasant pain. Preventive examination

is the main way to detect the initial stage of varicocele. Only 10-15% of patients note unpleasant symptoms which cause periodic pain. Among the others possible manifestations Varicocele can be identified as sagging of the scrotum, which provokes heaviness and discomfort in the heat and while walking. Typically, such sensations become aggravated during prolonged standing on the feet, in a sitting position and due to wearing uncomfortable. There may also be nagging pain and burning in the testicles. The pain syndrome can radiate to the lower back and hip and often intensifies in the evening.

In some cases, general weakness, decreased appetite, frequent urination, and irritability may additionally be noted. Patient complaints tend to increase as the disease progresses.

Advanced disease can be identified through self-examination. Visibility of veins and emerging asymmetry of the left and right sides scrotums with gradual sagging of the half affected by the disease are an accurate visual manifestation of varicocele.

How do doctors detect the disease?

When diagnosing varicocele, there are four degrees of the disease:

• First: a slight level of venous expansion, which cannot be detected visually due to the absence of convex veins. A diagnosis can only be made using an ultrasound of the scrotum, Dopplerography of the venous vessels and a spermogram, which helps determine signs of infertility.
• Second: The affected veins can only be felt while standing. There are no external manifestations, but a feeling of heaviness may appear during execution physical activity.
• Third: by palpation, the doctor can easily determine the lesion of the veins in any position of the patient’s body. In a vertical position, the veins descend to the bottom of the scrotum and slightly deform it. The testicle becomes swollen and atrophic. Pain syndrome is clearly manifested, which leads to reduced ability to work.
• Fourth: Reduction in testicular size becomes the most noticeable symptom.

For diagnosis, urologists use the following methods:

• Ultrasound (lying and standing): it is prescribed for a minor degree of development of the disease in order to better examine the vessels.
• Palpation: in a vertical position of the body, the doctor palpates the venous plexus.
• Valsalva maneuver: When the abdominal muscles are tense, the doctor palpates the enlarged veins.
• Spermogram: one of the methods that is used to determine infertility with varicocele.

How does the disease affect overall health?

Why is varicocele dangerous? The disease itself is not life-threatening and can be lived with. But often its presence leads to complications such as infertility and pain. As a result of the enveloping of the testicle in vessels, its temperature increases (1.5-2°C above body temperature) and the ability to thermoregulate is impaired. Extended varicose veins lead to a deterioration in oxygen supply to tissues and place mechanical stress on the testicle.

Stagnation of blood in the veins of the testicle negatively affects such a process as spermatogenesis. Egg plays main role in the production of sperm that mature in the epididymis. The effect of dilated veins on the health of the testicle can lead to inhibition of the process to a significant or complete extent.

Does varicocele affect the development of infertility?

Varicocele and infertility in men have a direct relationship. Disease of the veins of the spermatic cord is detected in 10-15% of the male population. Of this percentage, in 40% of cases, varicocele provokes inability to conceive. Although left-sided varicocele is usually common, the right testicle is also affected. This leads to a general decrease in spermatogenesis rates, a decrease in testosterone production and the appearance of antisperm antibodies, which are formed as a result of the unprotection of spermatogenic tissue from the body's immune reactions.

In medicine, there are several forms of development of male infertility associated with the expansion of the veins of the spermatic cord:

• Secretory (endocrine): a decrease in the quantitative and qualitative indicators of sperm occurs due to their construction defect. The main reasons that provoke this condition include varicocele, hydrocele of the testicular surface and lifestyle factors (smoking, stress, poor diet, infections, etc.).
• Immune: The body produces antibodies against sperm and testicular tissue. Inflammatory process in the testicle appears as a result of varicocele or trauma.

Treatment methods

The negative consequences of varicocele are eliminated through surgery. Methods involving the use medicines, refusal of physical activity and shapewear will not solve the problem.

The choice of surgical treatment may depend on the age and stage of the disease. One of the most modern methods To eliminate varicocele in adolescents and adult men, microsurgical varicocelectomy from a mini-access is considered. If slightly reduced results in the spermogram are observed and there are no other manifestations of the disease, a preventive visit to the urologist is prescribed.

Factors influencing the restoration of fertility

Is it possible to get pregnant and have children with varicocele? This is a question many families ask. Doctors cannot give a 100% guarantee, but they have long proven that treating the disease significantly increases the chances of having a child. Surgery itself is not a cure for infertility. By eliminating pathogenic factors, it helps create suitable conditions for improving spermatogenesis.

The favorable postoperative prognosis is based on the following factors:

• Age of the patient and advanced stage of the disease: the older the man and the longer he suffers from varicocele, the more difficult it is to achieve the desired result due to the severe degree of damage to the testicles.
• Disease stage: the degree of development of varicocele directly affects the percentage of infertility development.
• Bilateral or unilateral lesion: With bilateral varicocele, a state of complete absence of sperm may be observed, which is corrected with surgery.
• Hormonal factors: Low testosterone can be an obstacle to achieving recovery.
• Spermatogenesis: The degree of sperm damage and their number affect the success of treatment.

Good results are expected in patients who do not delay treatment after diagnosis.

Small deviations in spermatogenesis, the absence of visually pronounced abnormalities in the testicles and the young age of the patient contribute to a positive outcome in eliminating infertility. In such men, the fertility rate increases up to 60% and spermogram results improve up to 80% within six months or a year after the operation.

For example, the laparoscopic treatment method can increase sperm counts within 3 months in 87% of cases. Microsurgery allows you to achieve the same results, but requires more time to restore performance.

Varicocele

Varicocele and infertility

Varicocele is a fairly common disease that leads to decreased fertility in men.

If a married couple cannot conceive a child, contrary to popular belief, it is not always the woman's fault.

A fairly common reason for the absence of children in a couple is male infertility. Varicocele is a fairly common disease that leads to decreased fertility in men.

It is associated with pathological dilation of the veins of the testicle and spermatic cord.

Varicocele cause of infertility in men

Varicocele is the cause of infertility in many men who consult doctors about the impossibility of conceiving a child. When examined by an andrologist, a varicocele is discovered in approximately 40% of cases.

The likelihood of infertility with this disease is very high, although with a slight dilation of the veins of the pampiniform plexus, reproductive function may not be impaired.

Varicocele leads to infertility due to the influence of the following pathogenetic factors:

• overheating of the scrotum (the testicles are outside the body precisely because they need constant cooling under the influence external environment);
• oxygen starvation of testicular tissues, their atrophy;
• disruption of the blood-testis barrier, as a result of which the body begins to produce antibodies (immunity factors) against its own sperm.

Varicocele does not always cause infertility in men. To check whether this disease has affected the state of the reproductive system, you need to take a spermogram and a MAR test. These studies allow you to assess the quality of seminal fluid and determine the presence of antisperm antibodies.

Varicocele and pregnancy

To achieve pregnancy, you first need to cure the varicocele. Severe treatment (with a pronounced cosmetic defect, pain syndrome, infertility) is carried out using surgical methods.

In most cases, a man's natural fertility is restored after treatment of varicocele, and pregnancy becomes possible. This does not happen right away. It is advisable to take a spermogram for the first time after surgery no earlier than 3 months later. Reproductive function is usually restored six months to a year after surgery.

To make pregnancy more likely, varicocele surgery is treated with conservative methods. Drugs are prescribed whose action is aimed at restoring spermatogenesis. The course of therapy can last several months.

However, pregnancy after varicocele is not always possible. Sometimes fertility is not restored, or sperm quality improves very slowly. To find out whether pregnancy is possible, varicocele requires follow-up. From time to time after treatment, you need to take a spermogram to evaluate the qualitative and quantitative indicators of seminal fluid.

Varicocele and IVF

Infertility after varicocele may persist despite surgical treatment. This may occur due to atrophy of testicular tissue (testicular tissue) due to hypoxia (lack of oxygen), or due to the development of immunological infertility.

It is caused by a violation of the blood-testis barrier. Protective immune cells gain access to the testicular tissue and “get acquainted” with antigens located on the sperm membrane. As a result of the destructive effects of specific immunity factors, germ cells lose mobility, are destroyed or become resistant to the receptors of the female egg.

In these cases, even surgery performed for varicocele does not help restore fertility, and IVF remains the only option for overcoming infertility. Given the low quality of a man’s sperm, there is a need for ICSI - manual injection of specially selected single sperm into female eggs. Or PIXI - selection of fertile sperm before injection using hyaluron. In any case, with the help of assisted reproductive technologies, a man can become a father.

Men who do not want to undergo surgery often ask their doctor: is IVF possible for varicocele without surgical treatment? Yes, surgery is not mandatory for this disease.

If a patient is diagnosed with varicocele, surgical treatment is indicated in the following cases:

• deterioration in quality of life associated with symptoms of severe dilatation of the veins of the pampiniform plexus (pain in the scrotum, erectile dysfunction);
• progressive testicular atrophy, which is externally manifested by its decrease in size;
• decreased fertility (ability to conceive) and the patient’s desire to restore it.

Those. if nothing bothers a man and nothing hurts, and the only problem If there is a deterioration in the quality of sperm, then you can do IVF to conceive a child without resorting to surgical treatment.

Second common reason reason why spouses can use IVF is the reluctance to wait a long time for fertility to be restored after surgical treatment of varicocele. This process can take six months to a year, and in some cases more. Older couples sometimes do not have time to wait for such a long time, because the older the woman, the lower the chances of achieving pregnancy.