Tom and Sarah have been trying to conceive for over a year.  Sarah finally asked her gynecologist for help, and to both of their surprise they learned that the problem might be Tom’s.  When he had a thorough exam by his primary care doctor, Tom found out he has a varicocele (VAR-ih-koe-seel).  He hadn’t even noticed, but now that he knows about it he can feel it.  The next step is to figure out what their options are, because this may or may not be the actual reason Sarah has not gotten pregnant yet.  Time to do some investigation.

Are You Trying to Conceive with a Varicocele?  What is it exactly?

  • A varicocele is where there are abnormally dilated veins in the scrotum Are You Trying to Conceive with a Varicocele?
  • Present in 15% of the general population
  • Present in 40% of infertile males
  • Usually diagnosed age 15-30
  • Both sides are often affected, though the left side is usually more obvious
  • It is believed to be harmless

A varicocele is like varicose veins that are commonly seen in the legs.  The one way valves have failed, and the blood does not leave the scrotum easily, causing enlargement of the veins.

Possible Signs and Symptoms

  • Feels like a bag of worms if obvious
  • Painless lump, swelling or bulge within the scrotum
  • Shrinking of the testicle
  • Feeling of aching or heaviness within the testicle

None of all of these signs and symptoms may be present.

Diagnosis

  • Palpate (feel) the scrotum for enlarged veins
  • Ultrasound

Get a good physical examination by your physician.  You may be referred to a specialist.  The varicocele could be obviously visible, or not visible but easily felt.  Often it is only present by doing a valsalva maneuver (bearing down to increase pressure in the abdomen) to make it more obvious.  Sometimes it can only be found using a doppler ultrasound.

Should the varicocele be treated?

There is no conclusive evidence that having a varicocele is the cause of the higher rates of male infertility in some of these men.  There appears to be no improvement in infertility after surgery to repair a varicocele.  Sperm counts may increase, but the rate of pregnancy does not.

Remember, most men with varicoceles are able to father children.  Always do at least 3 semen analyses to evaluate if sperm abnormalities are even an issue.  You can have a varicocele with completely adequate sperm.  You can also have a varicocele with abnormal sperm, but the varicocele may not be the cause.

These facts do not support having this surgical procedure for male infertility.  There are potential risks.  They include infection, injury to the testicular structures and possible shrinking (atrophy) of the testicle, hydrocele (fluid in the testicle due to damage to the lymphatic drainage), and recurrence of the varicocele.

What Can I do to Increase My Fertility?

See the article “Causes of Male Infertility” and read more about Vibrant Nutrition in other posts.  There is much you can do to help yourself, and many ways of increasing your chances of having the child of your dreams.  Help with this is exactly what this blog is about.

To Your Vibrant Health!

Veronica Tilden, DO

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