Many men have dilated veins in the scrotum, which is the pouch containing the testicles. Doctors call these veins varicoceles . Many men with varicoceles have no symptoms, but some may have fertility problems. Varicoceles are common and affect 10 to 15% of men. Doctors continue to debate the role of varicoceles in infertility.
Some research suggests that treating a varicocele may improve fertility outcomes. However, a systematic review indicates that the available evidence is weak and that doctors need to do more research.
In this article, find out if a varicocele affects fertility.
What is a varicocele?
A varicocele occurs when a bulge results from dilated veins inside the scrotum. The swelling usually looks like a magnification above the testis, without discoloration. The pampiniform plexus is a group of veins inside the scrotum. These veins help cool the blood before it goes to the testicular artery, which supplies the testes with blood.
If the testicles are too hot, they cannot produce healthy semen. The health of sperm affects fertility. It is therefore essential that the veins can cool the blood. Most people with varicocele don't have symptoms, but some may have fertility problems. When a person has a varicocele, they may also experience swelling and tenderness in the scrotum.
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Do Varicoceles Cause Infertility ?
Most men with varicoceles do not have fertility problems. Infertility rates in people with varicoceles, however, are higher than in those without. This difference may be due to the fact that varicoceles interfere with the body's ability to make and store semen.
A 2012 meta-analysis of previous studies found that treating a varicocele could improve fertility, especially if the cause of a couple's infertility is unknown. However, the researchers stress that the evidence is weak and therefore more research is needed.
Also Read: VARICOCELE AND FERTILITY: NATURAL HEALING
The main concern with varicoceles is that the bulging of the veins can damage the sperm and reduce their number. In individuals with an average sperm count, a varicocele is unlikely to cause infertility.
When a couple cannot conceive, it is essential to do a variety of tests, including a sperm count, and not to assume that varicocele is necessarily the only cause.
Causes and risk factors
A varicocele occurs when the veins in the scrotum grow larger. Every vein has a valve that keeps blood from flowing back, but sometimes the valve fails. This causes blood to flow back, damaging the vein and causing swelling. Doctors do not fully understand what causes valve failure and varicocele. They are common and usually do not mean that a person has an underlying health problem.
Studies have proven that smoking can be a risk factor for varicocele because it damages a person's blood vessels. The same study found no link between alcohol or occupation and varicoceles.
Rarely, a growth in the stomach can put pressure on the veins, causing a varicocele. This problem is more common in men over 45.
In many people, a varicocele has no apparent cause.
Most men with varicoceles don't notice anything unusual, although some people report an occasional thrill or throbbing in the scrotum. Many affected people only find out that they have a varicocele after having had problems with infertility. A doctor can often diagnose a varicocele during a physical exam by examining the scrotum and looking for any unusual lumps and blood vessels.
If a doctor suspects a varicocele, they may order an ultrasound. This is a painless imaging test that allows the doctor to see the veins inside the scrotum.
If the person has fertility problems, the doctor may also order a semen analysis to check the quality of the semen.
Varicoceles that do not cause symptoms do not require treatment. A varicocele may need treatment when:
- A man has varicocele and a low sperm count or other semen problem.
- Varicocele causes pain or swelling.
- A couple has unexplained infertility and the male has varicocele.
When people choose to undergo treatment, they have two different options:
Embolization is a surgical procedure that temporarily cuts off the blood supply. A doctor can perform this procedure in their office under local anesthesia, which means that a person will not feel any pain in the area.
During embolization, a doctor inserts a needle into a vein usually through the groin. Sometimes they can insert a needle through the neck. The needle helps the doctor access the veins in the scrotum and block the varicocele. A person may experience pain and tenderness after the procedure, but the recovery time is short and the person can immediately resume normal activities.
A doctor can surgically remove a varicocele by blocking blood flow to the damaged vein. This operation is called a varicocelectomy .
A person will undergo general anesthesia before the varicocelectomy in order to be asleep and unable to feel any pain during the procedure. A person may experience pain and tenderness for several days.
Surgery is more effective is embolization with a failure rate of less than 5%. Laparoscopic surgery uses a smaller incision than open surgery and requires less recovery time but also requires a very skilled surgeon. Open surgery uses a wider cut in the scrotum.
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