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Surgery or embolisation for varicocele in subfertile men
1Department of Obstetrics & Gynaecology, Academisch Ziekenhuis Maastricht, P.O. Box 5800, Maastricht, Netherlands, 6202 AZ.
The Cochrane Database of Systematic Reviews
|July 22, 2004
Summary
Varicocele treatment does not improve pregnancy rates in subfertile couples where the male has varicocele as the only issue. This review found no evidence that treating varicoceles enhances conception chances for these couples.
Area of Science:
- Reproductive Medicine
- Urology
- Male Infertility
Background:
- Varicocele, a condition involving enlarged veins in the scrotum, is often linked to male subfertility.
- The exact mechanisms by which varicoceles affect fertility and how treatment restores 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 within subfertile couples.
- To determine if surgical or radiological interventions for varicocele improve conception outcomes.
Main Methods:
- A systematic review of randomized controlled trials (RCTs) was conducted.
- Searches included major databases (Cochrane, MEDLINE, EMBASE) and specialist journals up to May 2004.
- RCTs reporting pregnancy rates in treated versus untreated groups were included.
Main Results:
- Eight studies involving 1,030 men were analyzed.
- The pooled odds ratio for pregnancy following varicocele treatment was 1.10 (95% CI 0.73–1.68).
- This indicates no statistically significant benefit of varicocele treatment over expectant management.
Conclusions:
- Current evidence does not support varicocele treatment for improving conception rates in couples with unexplained subfertility.
- No demonstrable benefit was found for varicocele treatment when it is the sole identified issue in male partners.