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AmyAALC posted:
It is estimated that as many as 40% of infertile men are affected by varicocele. Incidents of varicocele seem to be especially high with men experiencing secondary infertility. Varicocele is the presence of varicose veins around the testicles. It occurs when blood does not circulate properly out of the testicles. The increase in blood leads to a raise in temperature in the testicles. This causes abnormal testosterone levels which hinder the production and maturation of the sperm. Although varicocele can occur in both testicles, about 85% of the time it affects the left testicle.
While the majority of men are asymptomatic, in some instances a man may experience one or more of the symptoms associated with varicocele which include:
· Pain in the testicle
· A heavy feeling in the testicle
· Visible shrinkage of the testicle(s)
· An enlarged vein that is visible or found by touch
· Infertility
While large veins may be visible, medium sized veins can usually only be identified by feeling the area. Varicocele is often diagnosed by a doctor during a physical examination. However, smaller varicocele veins may require the use of a diagnostic device like an ultrasound. A sperm analysis may also indicate varicocele. Men affected by this type of varicose vein will usually produce sperm that is underdeveloped, damaged, dying or dead.
Treatment of varicocele depends on the severity of the veins. For men who have a mild case and are experiencing no symptoms, using an athletic support or wearing close-fitting underwear is usually sufficient to provide support to the scrotum, thereby managing the problem.
Surgical options are available for those men who are having pain, are experiencing infertility or have testicular damage caused by varicocele. Although a recurrence of the varicose veins will happen to approximately 5% to 20% of men, at least half the men who have surgery for varicocele are able to conceive a child within a year.
An_206295 responded:
We have been TTC for over a year and my husband was just diagnosed with a varicocele after getting a sperm analysis back with only 400,000 sperm (the average man has 60 million). He has surgery scheduled to get the varicocele repaired, but I keep hearing sad stories of varicocele repair with unsuccessful results. Anyone on here been through it and have any hope for me?
AmyAALC replied to An_206295's response:
Semen improvement is expected in up to 70% of men and pregnancy in up to 60% of couples within the first two years after successful repair (study by Madagar et al. Fertility & Sterility, vol.63, no., 1995).

It can take about 6 months after the repair to see a noticeable difference in the semen analysis parameters but I think investing the time is worth the shot at a natural pregnancy compared to moving right into IVF. Good luck and keep us posted on your journey!

shellgg replied to AmyAALC's response:
Hi Amy,
I couldn't find how to post my own discussion so I apoligize for intruding on this one.
I just need a second opinion. My husband had the ovum penetration test done and the results came back abnormal(nurse said "a little low." It was in the 1-5 category. His count has significantly improved in the last three years. When we did SA's three years ago, one came back as 4 million and the other as 6 million. Normal morph and motility. They did a SA during the OPT test and the count is now 20 million with 50% motility. I have no idea why the difference but I am glad. I asked my Dr. if we could try IUI first since my insurance pays for it and he said he would be willing to try although the chances of success were low. He wants to give me egg stimulating drugs to increase the egg production as to give the sperm a better chance. What is your opinion on the OPT test coming back abnormal, the normal count, and our chances at IUI. I realize that IVF is a better option but, since our insurance pays for IUI, I would like to give it a try.

Thank you
shellgg replied to AmyAALC's response:
Thanks Amy!
Actually, my husband did not have a variocele but had a testicular torsion which may have produced antibodies. I believe that is the reason the OPT test came back abnormal. I am hoping IUI will work since the count has improved to 20 million. The dr. said the chances are low, b/c of the OPT results, but its worth a try.
Thanks again
AmyAALC replied to shellgg's response:
Testicular torsion or any injury to the testicles can cause a man to have antibodies so it is possible he has antibodies binding to the head region causing penetration problems. I would give the IUI a couple tries. One average it takes 3-5 so it might take some time but work trying if your insurance is covering. Some labs will have the men collect the ejaculate directly into a cup containing wash media to help dilute the sperm away from the antibodies. The sperm is taken through a couple wash steps to remove seminal fluid and concentrate the sperm into a small volume (0.5 ml or cc). If the IUI does not work you might have a sperm antibodies binding assay to see what percent of the sperm have head binding which cause problems with that penetration. If high IVF with ICSI would be your next step.

Good luck and please keep us posted on your journey!


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