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I have a cousin who told me the effects of the adolescent varicocele become apparent around puberty. Since I have noticed something I think is testicular atrophy, or loss of testicular size, I am afraid this is my problem. I have heard that testicular atrophy is progressive as the young man ages. That is why I want you to tell me more about this problem called varicocele, should I have doctor’s exam because I do not want to experience infertility one day because of this?

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Varicoceles are an abnormal collection of dilated veins above the testicles. This problem is present in 15% of men. Males with varicoceles have a progressive injury to the cells in the testes that produce sperm and testosterone. Varicocele repair not only stops the testicular injury, but also can reverse the cellular changes. That is why it is improving both male fertility and increasing testosterone. Varicoceles are found in 50% of men presenting with primary infertility and 69% of men with secondary infertility, so this is serious problem. Varicoceles were described as the most correctable factor when treating poor semen quality. There have been many studies that show how repairing a varicocele improves sperm quality and increases pregnancy rates. Following varicocele repair that is recommended, spontaneous pregnancy rate increases to 40%, with 75% of men having improved sperm parameters. Even men with azoospermia, which mean they have zero sperm on semen analysis, repair of varicocele allowed for sperm production in 40-60%, so if you doubt about varicocele you should have it repaired to prevent infertility.
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