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Varicocele: Warning Signs in Male Fertility

By Dr. Jesús Alberto Félix Atondo

15% of the world’s male population are born with varicocele. Most will go undiagnosed in their lifetime. Untreated varicocele can lead to male infertility. Understanding varicocele’s warning signs in male fertility can lead to a positive fertility outcome in a male’s reproductive years.


Anatomy of a Varicocele

 Most men are born with two testicles. Each testicle has a testicular artery that supplies oxygenated blood and a vein that returns the deoxygenated blood to the heart. On each side of the scrotum, a group of veins known as the pampiniform plexus transports deoxygenated blood from the testicle to the testicular vein.

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When the pampiniform plexus becomes enlarged, it is diagnosed as a varicocele, a varicosity of these veins. A testicular varicocele is more likely to happen on the left testicle than the right, but some men are diagnosed with a right varicocele or a varicocele of both testicles.

Approximately 20% of adolescent males are diagnosed with varicocele, which develops during puberty, with some of them resolving on their own. The varicocele enlarges over time, often without symptoms.

A diagnosis of varicocele doesn’t always lead to infertility.


Signs and Symptoms of Varicocele

 While some males have discomfort or pain, others never have signs or symptoms. Signs and symptoms include:

  • Swelling – Your testicles and scrotum feel and appear swollen.
  • Two different-sized testicles – Testicles should be close to the same size. In varicocele, your testicles are noticeably different in size, and the affected testicle may appear shrunken.
  • Discomfort/Pain – A dull aching that is more noticeable while standing or as the day gets longer. Laying down often relieves this discomfort.
  • A Scrotal Mass – Once the testicular varicocele enlarges, it looks like a varicose mass above your testicle. If the varicocele is small, you may not notice it but will feel it when touched.
  • Infertility – the inability to conceive with your partner in a year.

Why is it important to treat Varicocele?

How Varicocele Causes Male Infertility

It is believed sperm development is affected by the raised temperature of your testicles caused by the varicocele.

The temperature increase affects the outer coating, membrane, and DNA of the sperm, damaging the health of your sperm.

The temperature also causes a decrease in your testosterone. Testosterone, the male hormone responsible for male attributes in puberty, assists in strengthening muscle and bone and increases your sex drive. A drop in your testosterone level will cause depression, shrinking of your testicles, decreased sex drive, and loss of muscle mass.

A lack of sperm in your semen is also caused by testicular varicocele. This condition is called Azoospermia and is one of the most common causes of infertility in males.

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Is Varicocele Treatable?

While a varicocele can be serious, it is not life-threatening. It is responsible for approximately 40% of all male infertility, but many males with a varicocele have no issues conceiving with their partner!

Varicoceles are treated based on their severity. If you are symptomless and it is not affecting your fertility, it usually isn’t treated.

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Lifestyle changes may be necessary. You may need to wear a jockstrap if you are on your feet for many hours or during exercise. You may also need tighter underwear. Unfortunately, you may also need to avoid activities that cause pain or discomfort.

Applying ice packs to your scrotum can help relieve discomfort if you are plagued with discomfort or pain. Always wrap the ice pack before applying it and remove it after fifteen minutes. Cold packs should NEVER be applied to bare skin!

NSAIDs like Ibuprofen can help resolve pain or discomfort in the scrotum or testicles. Never self-medicate! Always check with your physician before taking OTC meds.

Varicoceles that are severely painful or affect fertility can be treated surgically. This procedure is known as a varicocelectomy, or cutting of the enlarged veins that are then sealed. Once the surgical procedure is completed, blood flow is redirected to the healthy veins in your scrotum.

After a varicocelectomy, it takes approximately three to six months for an increase in the quality and quantity of your sperm. Very rarely does varicocele cause permanent infertility. Most males can expect a 30% regain of fertility, increasing their chances of spontaneous pregnancy. However, sperm quality and the age of both partners can affect the results.

For most couples, the improved semen quality combined with intrauterine insemination offers an outstanding chance of conceiving naturally!

If you or someone you know has difficulty conceiving a child, contact us at The Fertility Center Mexico. We offer male and female infertility diagnosis and cutting-edge treatment at more affordable rates than the same treatments in the U.S. Our Fertility Specialists are known experts in the field and have assisted many couples struggling to conceive the family they have longed for.

Our bilingual staff can answer questions and assist with forms and necessary documentation. Contact us and start your journey to conception!

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Dr. Jesús Alberto Félix Atondo

Gynecology, Obstetrics and Biology of Human Reproduction Surgeon at the Autonomous University of Guadalajara, specialist Biologist of Human Reproduction by the Mexican Institute of Infertility.

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