Fact And Fiction About Varicocele

If you have been told you have varicocele and you need surgical correction, can you really expect the procedure to help you become a father? Here are five myths to dismiss as you make your decision.

1. Surgical correction of varicocele makes your balls bigger.

When vascular surgeons first started making varicocele correction generally available, most of their patients were boys who were just hitting puberty. In young teens and pre-teen males, correcting circulatory problems makes a measurable difference in testicle size.

In adult men seeking treatment for infertility, however, testes size (the testes being the reproductive organ in the testicle, covered by the scrotum) is not usually the issue unless there is insufficient secretion of a hormone called follicle stimulating hormone, or FSH. Men who develop varicocele after adolescence usually have testicles of normal size.

2. The more visible the vein, the more urgent it is to have it repaired.

Men who have varicocele are more likely to be infertile, but the size of the varicocele actually has no relationship to semen quality. Whether the vein is obvious on visual inspection, when the doctor feels the testicles, or only when the man is bearing down hard on his peri-anal muscles, size actually does not matter.

3. Varicocele is caused by taking cold showers.

While taking a cold shower does cause the scrotum to contract, and it is necessary for the examination room to be warm for the doctor to be able to find a varicocele, cooling the skin does not reduce the production of sperm. In fact, because overheating the testes is more likely to be a problem, taking cold showers might slightly increase the production of healthy sperm, and taking hot showers might slightly reduce it.

4. If you don't fix a varicocele now, you will experience even greater problems with infertility later.

While it may seem logical that circulatory problems would lead to deterioration in testicular tissue as a man ages, only one study found any evidence at all that this actually happens, and this study found that it was sperm concentration that diminished over time, not sperm viability. That is, the sperm continued to be active, but it would take a greater volume of semen to increase the likelihood of conception. Couples usually have more difficult conceiving as they get older, but this may also be due to changes in female fertility.

And the most important myth about varicocele is the most often quoted myth about varicocele.

5. Surgical correction of varicocele increases the likelihood a man will become a father.

Amazingly, numerous studies confirmed that varicocelectomy increased various measures of semen quality (typically increasing sperm concentration in semen 30% to 60%), but until December of 2012 no study ever confirmed that couples are more likely to become pregnant after the male partner has varicocele correction.

An article published in January of 2013 announced findings of a study that the operation is helpful when the underlying problem in the man's infertility is DNA fragmentation (broken strands of DNA) in his sperm. Even this study, however, did not find that the procedure necessarily results in more healthy births.

If you aren't going to have an operation for varicocele, then what is there to do? The data show that it actually usually works out better just to try to conceive in an informed fashion, it is always best to seek other, more appropriate medical interventions. If pregnancy does not occur after a year of trying, it is always best to seek a doctor's help.