What is a Varicocele and how does it affect Male Fertility?


What is a Varicocele and how does it affect Male Fertility?


An overview on Varicocele

A varicocele is bulging of the veins within the loose bag of skin that holds testicles. A varicocele is akin to a varicose vein that affects the legs. Varicocele is one of the causes of infertility in men leading to low sperm production and poor sperm quality, which could result in male infertility. It is unclear what triggers varicoceles. It is not necessary that all varicoceles impact sperm production.
In majority of instances, varicoceles develop over a period. Varicoceles can be classified as Grade 1, Grade 2 and Grade 3 varicoceles. Grade 1 and 2 varicoceles are not visible but can be detected during a physical examination by the doctor, while a Grade 3 varicocele easily identifiable. Depending on the grade of varicocele present, some individuals may not require treatment. As time progresses, there may be swelling of varicoceles and it becomes more visible. Further, if a varicocele results in symptoms, it can be treated surgically.

Young men are equally susceptible to Varicocele

Typically, varicoceles occur in adolescence. In young men, a varicocele develops around the testicles rather than the legs. The existence of a varicocele weakens sperm production. The reason is when certain veins in the scrotum get enlarged due to breakdown in some of the valves involved in pumping the blood. Further, it affects mere one side of testicle, usually the left one. Though, it may not lead to serious complications, it could have a negative impact on male fertility. Nearly, 15 percent of adult male population are facing this problem.
Despite low sperm quality, many men with varicoceles continue to face sufficient sperm quality. As a result, men attain progeny late in life.

Effect of a Varicocele on Sperm Concentration

Sperm count was noticeably lower in men with grade 3 varicocele than in men without the condition. Also, men with grade 1 varicocele tend to have a low sperm count about 20% lower than men who do not have the incidence. Most of men are not aware of the fact that there is an immense risk of lowered semen quality, mainly affecting and lowering sperm count due to the mildest grade of varicocele.

Impact of a Varicocele on Sperm DNA Fragmentation levels

Varicocele is integrated with abnormal levels of DNA damage in spermatozoa due to oxidative stress.High levels of sperm DNA fragmentation will have a negative bearing on embryo development and pregnancy rates. Studies have also shown that Sperm DNA Fragmentation levels show a significant decrease after medical intervention with a varicocele.

Varicocele Symptoms

Often, a varicocele displays no symptoms or signs. Unusually, it may generate pain that may:

  • Differs from dull ache/pain to feeling of heaviness in the testicle, which becomes worse during the day, particularly in hot weather or after physical exertion
  • Scrotal pain, especially when standing over longer periods
  • Testicle appears smaller on the Varicocele side
  • Relief from pain when lying on the back

The individual should consult a doctor if they notice:

  • A lump
  • Fertility problems
  • Bulge in the scrotum
  • Veins that display as usually big or twisted
  • Any perceptible change in the size, form, or appearance of the testes

Varicocele Treatment

Varicocele treatment may not be required unless an individual is impacted by low sperm count and suffers from infertility for at least two years. However, if varicocele causes persistent pain, surgery becomes unavoidable. Surgical options are of three types:

  • Varicocelectomy
  • Laparoscopic, and
  • Percutaneous embolization

Varicocele repair yields favourable pregnancy rates. Although varicocele treatment generally enhances sperm features, it is not clear whether an untreated varicocele results in progressive deterioration of sperm quality over time.
The objective of surgery is to round off the impacted vein to redirect the blood flow into normal veins. In instances of male infertility, varicocele treatment may cure infertility problem or enhance the quality of sperm if techniques like In Vitro Fertilization (IVF) are to be employed.

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