Male infertility is responsible for almost half of all cases of couples experiencing trouble conceiving. While it is true that men have far less causes of infertility compared to women, varicocele (pronounced VAR-ih-koe-seel) is a leading cause of male infertility. This condition is quite common. About 40% of infertile men have a varicocele.

WHAT IS A VARICOCELE?

Varicocele is an enlarged vein or cluster of veins within the scrotum, very similar to a varicose vein of the leg. The varicocele drains blood away from one or both of the testicles.

WHAT CAUSES A VARICOCELE?

In a typical varicose vein of the leg, the valves in the vein lose strength and fail. With varicocele, the valves never formed, so as a boy goes through puberty and the reproductive organs grow, a varicocele may form.

No one is quite sure what causes a varicocele to happen. Varicoceles most often form during puberty and more often on the left side. This is probably due to the position of the left testicular vein.

Over time, varicoceles may become larger (dilate), increasing the chance of infertility. Regardless of the side that the varicocele is on, sperm production in either testicle or both may be affected.

SYMPTOMS OF VARICOCELE

• Discomfort of the scrotum and testicles – dull, heavy or sharp
• A feeling of relief when lying on your back
• Discomfort worsens over the course of the day
• A noticeable enlargement in an area of the scrotum

Important note: There are several other conditions that may cause a noticeable mass of the scrotum.

HOW A VARICOCELE MAY CAUSE LOW SPERM COUNT AND POOR SPERM HEALTH

Infertility and Atrophy of the Affected Testicle
The testes are made up of sperm-producing tubules, which are responsible for the “bulk” and shape of each testicle. The affected testicle may shrink and become soft over time, due to the malfunctioning valves allowing blood to pool in the veins. The pooling blood results in increased pressure in the veins, which leaves the tissues of the testes and sperm to be exposed to damaging toxins in the blood. This toxin exposure may also play a role in the quality and quantity of sperm.

Another way a varicocele may impact male reproduction is through testicular temperature alteration. The testicular veins are responsible for cooling the blood in the testicular artery. The natural ability of the testicular veins to do this ensures that proper temperature is maintained for sperm production. If blood flow is blocked due to varicocele, testicular temperature may become too high, affecting sperm health, including count, formation (morphology) and movement (motility).