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Related Experiment Videos

Surgery or embolisation for varicocele in subfertile men.

J L Evers1, J A Collins, P Vandekerckhove

  • 1Department of Obstetrics & Gynaecology, Research Institute GROW, Academisch ziekenhuis Maastricht & Maastricht University, P.O. Box 5800, Maastricht, Netherlands, 6202 AZ. jev@sgyn.azm.nl

The Cochrane Database of Systematic Reviews
|May 2, 2001
PubMed
Summary

Varicocele treatment shows insufficient evidence for improving pregnancy rates in subfertile couples. More research is needed to confirm if varicocelectomy benefits male fertility and resolves subfertility issues.

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Area of Science:

  • Reproductive Medicine
  • Urology
  • Male Infertility

Background:

  • Varicocele, a varicosity of the pampiniform plexus, is linked to male subfertility.
  • The exact mechanisms by which varicoceles impair fertility and how varicocelectomy resolves it remain unclear.
  • The causal relationship between varicoceles and fertility impairment is debated.

Purpose of the Study:

  • To evaluate the impact of varicocele treatment on pregnancy rates in subfertile couples.
  • To synthesize evidence from randomized controlled trials (RCTs) on varicocelectomy outcomes.

Main Methods:

  • Systematic review of RCTs identified through specialized databases and journal searches (1966-2000).
  • Inclusion criteria: relevant trials reporting pregnancy rates, comparing treated (ligation/embolization) and untreated groups.

Related Experiment Videos

  • Five studies were analyzed, with data from a large WHO megatrial pending.

    • Main Results:

    • Only one study reported a statistically significant improvement in pregnancy rates after varicocele treatment.
    • The combined analysis of five studies showed no significant effect of varicocele treatment on pregnancy rates (RR 1.06, OR 1.15).
    • Individual studies did not consistently demonstrate improved fertility outcomes post-treatment.

    Conclusions:

    • There is insufficient evidence to support varicocele treatment for improving spontaneous pregnancy chances in couples with unexplained subfertility.
    • Further high-quality research, including the awaited WHO data, is necessary to clarify the role of varicocelectomy in male fertility.