Varicocele is one of the most common and most treatable causes of male infertility. Many men with varicocele have no symptoms and may not even know they have it. Others may experience discomfort, swelling, or changes in sperm quality. However, having a varicocele does not automatically mean a man will have fertility problems.
This blog explains what a varicocele is, how it can affect sperm, and how to know whether treatment is needed or not.
What Is a Varicocele?
A varicocele is a group of enlarged veins inside the scrotum, above the testicle. It is similar to varicose veins in the legs. These veins carry blood away from the testicles, and when blood does not flow out efficiently, it can collect in the veins, causing them to widen.
Varicoceles commonly develop during puberty and may become more noticeable over time. They usually occur on the left side, but they can affect both sides. It usually causes pain or swelling, while in some, it remains unnoticed until they undergo fertility evaluation.
How Does Varicocele Affect Male Fertility?
The testicles need suitable conditions to produce healthy sperm, but varicocele may interfere with these conditions and affect sperm production or quality in some men. Here are a few ways this can happen:
1. Increased temperature around the testicles
The ideal temperature for the testicles is slightly lower than the body’s core temperature, but varicocele interferes with normal cooling of he testicles and affects sperm production.
2. Changes in Sperm Count
Some men with varicocele usually have a lower sperm count, which means fewer sperm may be present in the semen, reducing the chances of conception in certain cases.
3. Reduced Sperm Movement
Sperm need to move effectively to reach the egg and fertilise it. Varicocele may affect sperm motility.
4. Changes in Sperm Shape and Quality
Varicocele may also be associated with changes in sperm morphology, or shape, and increased oxidative stress affecting sperm function in some men
Note: Not every man with varicocele experiences these changes. Some men have normal sperm parameters and are able to become biological fathers. A semen analysis and clinical evaluation help determine whether the condition may be affecting fertility.
What are the symptoms of a Varicocele
Many men do not experience any symptoms at all, and that’s the reason it remains hidden for years; the only way to find out is through fertility testing. However, if symptoms occur, then they are like:
- A dull pain or heaviness in the testicles worsens after prolonged standing and feels better when lying down.
- Swelling in the scrotum with enlarged veins that look like a cluster of twisted cords above
- A soft lump above the testicle that feels like a bunch of worms
- The one affected testicle may look smaller than the other.
- Some men may experience a sense of weight or discomfort in the scrotum.
How Is a Varicocele Diagnosed?
A doctor may diagnose varicocele through various assessments and recommend additional tests when needed.
1. Physical Examination
The doctor examines the scrotum, checks the size of the testicles, and detects the enlarged veins while the patient is standing and may ask them to bear down for easy visibility.
2. Semen Analysis
A semen analysis evaluates sperm count, movement, shape, and other semen parameters to determine the quality and health of the sperm. If the results are abnormal, then it does not automatically mean varicocele. Doctors will recommend further evaluations based on the reports.
3. Scrotal Ultrasound
When the physical examination is unclear, then an ultrasound is needed to assess the veins and structures around the testicles. Although it is not needed for every patient.
4. Hormone Tests
If there are signs of a hormonal problem or impaired sperm production, blood tests may be advised to assess hormones such as testosterone and follicle-stimulating hormone (FSH). These findings help doctors understand the condition and decide whether observation, treatment, or further fertility care may be appropriate.
Does Every Varicocele Need Treatment?
Not every varicocele needs treatment, especially when a man has no discomfort, normal testicular development, and no fertility concerns; then doctors usually recommend monitoring instead of direct intervention.
Treatment is usually considered when there is persistent pain, testicular growth concerns, or infertility accompanied by a clinically detectable varicocele and abnormal semen parameters. The treatment plan depends on the individual’s symptoms, test reports, and their reproductive goals. The following are the treatment plans available:
- Varicocele repair surgery
The varicocele repair surgery is also called varicocelectomy, a procedure that closes the affected veins so that the blood can flow through healthier veins. For some men, this procedure could improve their sperm count and other semen parameters, but it may take months to show the effect on sperm health.
It should also be noted that surgery may have potential risks like recurrence of the varicocele, fluid collection around the testicle, and other surgical complications, which need to be discussed with the doctor. - Varicocele Embolisation
It is an alternative procedure to surgery which depends on the patient’s condition, where the specialist sends a thin catheter into the affected vein and blocks it. This helps in redirecting the blood flow through other veins. - Fertility treatment
Assisted reproductive techniques (ART) are considered when pregnancy is not happening, or some other fertility factors are present. It may include IUI, IVF, or IVF with ICSI. But the treatment itself does not guarantee pregnancy.
How Can Ekam Fertility Help You With Varicocele and Male Infertility?
At Ekam Fertility and Women, we don’t directly jump to treatment. Instead, we look at your semen analysis and hormone levels, have a couple evaluations, and based on the reports, plan the proper personalised treatment that is most convenient for you.
If you are looking for the male infertility clinic in Hyderabad, then Ekam Fertility and Women in Kokapet, Hyderabad. Under the guidance of fertility specialist Dr. Nishchala Reddy and her team, the treatment is planned around your condition and reproductive goals.