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Updated: May 17, 2026
03:06
Combination of High Ligation and Intraoperative Embolization Using Polidocanol for Treatment of Varicoceles
Published on: December 22, 2023
Surgery or embolization for varicoceles in subfertile men.
Anja C J Kroese1, Natascha M de Lange, John Collins
1Maxima Medical Centre, Veldhoven, Netherlands.
The Cochrane Database of Systematic Reviews
|October 19, 2012
Summary
Varicocele treatment may improve pregnancy rates in subfertile couples. However, evidence quality is very low, necessitating further research on live birth outcomes.
Area of Science:
- Reproductive Medicine
- Urology
- Andrology
Background:
- Varicocele, characterized by dilated scrotal blood vessels, is linked to male subfertility.
- The exact mechanisms of varicocele's impact on fertility and the benefits of surgical correction remain unclear.
- The causal relationship between pampiniform plexus distension and fertility impairment is debated.
Purpose of the Study:
- To assess the impact of varicocele treatment on live birth and pregnancy rates in infertile couples.
- To evaluate the efficacy of varicocele interventions in men with subfertility.
Main Methods:
- Systematic review and meta-analysis of randomized controlled trials (RCTs).
- Searched multiple databases (Cochrane, MEDLINE, EMBASE, PsycINFO) and handsearched journals.
- Included RCTs comparing varicocele treatment (ligation/embolization) versus placebo/no treatment, reporting pregnancy or live birth rates.
Main Results:
- Meta-analysis of 10 studies (894 men) showed a potential benefit for varicocele treatment on pregnancy rates (OR 1.47, 95% CI 1.05-2.05).
- Number needed to treat (NNT) for pregnancy was 17; subgroup analysis (5 studies) showed higher benefit (OR 2.39, NNT 7).
- Evidence quality was very low, with significant heterogeneity and reduced significance in sensitivity analyses.
Conclusions:
- Varicocele treatment may enhance pregnancy chances in couples with unexplained subfertility.
- Current evidence is inconclusive due to very low quality and lack of live birth data.
- Further high-quality research focusing on live birth and pregnancy rates is required.
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