Should azoospermic patients with varicocele disease undergo surgery to recover fertility?

Rev Assoc Med Bras (1992). 2017 Apr;63(4):332-335. doi: 10.1590/1806-9282.63.04.332.

Abstract

Introduction:: Varicocele disease is well-known cause of infertility in men. The presence of spermatic varices veins create a hostile environment to spermatogenesis. It results in reduced quality of the sperm production and in some cases can determine a total absence of sperm. The varicocelectomy procedure in patients with non-obstructive azoospermia (NOA) can raise the rates of sperm in the semen analysis. A positive rate for sperm, even if very low, may be sufficient to enable the capture of sperm intended for in-vitro fertilization without the use of donor sperm.

Objetive:: To evaluate the raise of sperm in NOA patients with varicocele disease who were submitted to a bilateral procedure to recovery sperm production.

Method:: We analized the sperm results of 25 NOA patients who undergone to a bilateral varicocelectomy procedure.

Results:: From a total of 25 patients, three (12%) recovered sperm count four months after procedure. One year after the procedure, five (20%) patients recovered sperm production.

Conclusion:: Patients with varicocele disease and azoospermia, without genetic changes or obstruction of the spermatic tract, should undergo surgical procedure to recover sperm.

MeSH terms

  • Azoospermia / physiopathology
  • Azoospermia / surgery*
  • Humans
  • Male
  • Reproducibility of Results
  • Retrospective Studies
  • Sperm Count
  • Spermatozoa*
  • Time Factors
  • Treatment Outcome
  • Urologic Surgical Procedures, Male / methods
  • Varicocele / physiopathology
  • Varicocele / surgery*

Supplementary concepts

  • Azoospermia, Nonobstructive