Translational Health Reports

The Role of Varicocelectomy in Enhancing Fertility Outcomes: A Review Article

Document Type : Review Article

Authors

Ahmad Deylami 1
Mehran Frouzanian 2
Mehdi Younesi Rostami 1
Behkam Rezaiemehr 1
Amirsaleh Abdollahi 1
Mohadeseh Modanlu 3
Maryam Shahbazinia 4
AmirReza Ranjbar 5
Fatemeh Rajabian 5

1 Department of Urology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Mazandaran, Iran

2 Student Research Center, School of Medicine, Mazandaran University of Medical Sciences, Sari, Mazandaran, Iran

3 Department of Medical Sciences, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran

4 Department of Pharmacy, Mazandaran University of Medical Sciences, Sari, Mazandaran, Iran

5 Student Research Center, Mazandaran University of Medical Sciences, Sari, Iran

https://doi.org/10.22034/thr.2024.212236
Abstract
Varicocele is the leading cause of male infertility and can often be corrected or improved through a range of surgical and radiological methods. Consequently, it appears logical that varicocele should be treated in infertile men who have this condition. Varicocele, an enlargement of the pampiniform plexus veins affecting 15–20% of men, is more common in those with infertility concerns. Its impact on spermatogenesis is linked to oxidative stress, hypoxia, and immune responses, which may be alleviated by varicocelectomy. Varicocelectomy has been associated with improvements in sexual function, hormonal profiles, and fertility, particularly in men with hypogonadism. This review evaluates its effects on testosterone levels, semen quality, and fertility outcomes, highlighting the advantages of microsurgical varicocelectomy, such as improved sperm quality, higher spontaneous pregnancy rates, and fewer complications. However, patient outcomes depend on surgical indications, pre-existing conditions, and individual expectations.  Emerging evidence suggests that repairing varicoceles before assisted reproductive technology (ART) can enhance fertility outcomes. Further studies are needed to refine treatment criteria and expand options for diverse patient groups, including adolescents and men with pain-related varicoceles. The review also emphasizes the need for standardized diagnostic and treatment protocols.

Keywords

Varicocele
Male Infertility
Varicocelectomy
Oxidative Stress
Spermatogenesis
Testosterone Levels
Semen Quality
Assisted Reproductive Technology

Home

Guide for Authors

Submit Manuscript

Reviewers

Contact Us