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Varicocele repair in the era of modern assisted reproductive techniques

McIntyre, Matthew; Hsieh, Tung-Chin; Lipshultz, Larry

doi: 10.1097/MOU.0b013e328358e191
VARICOCELE: STANDARD AND ALTERNATIVE INDICATIONS FOR REPAIR: Edited by Peter N. Schlegel
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Purpose of review This review looks at the literature on varicocele repair and its effect on assisted reproductive techniques. The effects of varicocele correction on improved sperm production have been well documented with semen analysis data. What remain to be elucidated are the causes of the varicocele effect and how correction of the resultant pathophysiology may affect the outcomes of modern assisted reproductive technology.

Recent findings Basic science research shows us that varicoceles exert deleterious effects on Leydig cells, Sertoli cells, and germ cells via very different mechanisms. The effects of varicocele correction on the reproductive potential of sperm are less well understood. Clinical research has shown improved semen parameters, DNA integrity, and assisted reproductive technology outcomes after varicocele repair.

Summary Varicocele correction presents a possible method to optimize a couples’ reproductive potential or decrease the need for complex assisted reproductive technology.

Baylor College of Medicine, Houston, Texas, USA

Correspondence to Larry Lipshultz, MD, Baylor College of Medicine, 6624 Fannin St, Suite 1700, Houston, TX 77030, USA. Tel: +1 713 798 6163; fax: +1 713 798 6007; e-mail: larryl@bcm.edu

© 2012 Lippincott Williams & Wilkins, Inc.