Live Birth Rates After Varicocele Embolization in Patients After Failed In Vitro Fertilization With Intracytoplasmic...

Area of Science:

• Reproductive Medicine
• Urology
• Infertility Treatment

Background:

• In vitro fertilization with intracytoplasmic sperm injection (IVF-ICSI) has limitations despite bypassing sperm count, motility, and morphology issues.
• Varicocele is a common cause of male factor infertility, often associated with failed assisted reproductive technologies.

Purpose of the Study:

• To evaluate the efficacy of varicocele embolization (VE) in couples experiencing infertility due to male factors, specifically after prior IVF-ICSI failures.
• To assess the impact of VE on achieving live births (LB) in this challenging patient group.

Main Methods:

• A retrospective cohort study of 42 couples with male factor infertility and prior unsuccessful IVF-ICSI cycles.
• Male partners underwent transcatheter embolization for left or bilateral varicoceles; maternal age was ≤35, with ≥24 months follow-up.
• Data collected included pre- and post-VE outcomes, with live birth as the primary endpoint.

Main Results:

• Following VE, 36 of 42 couples (86%) achieved 60 live births (65 children) over a median 54-month follow-up.
• Of these, 28 couples had 36 live births through subsequent IVF-ICSI cycles, and 15 couples achieved natural conception.
• One couple had a live birth following intrauterine insemination.

Conclusions:

• Varicocele embolization may offer a viable treatment option for sperm function defects in varicocele-related male infertility that are not fully addressed by IVF-ICSI.
• VE could be a beneficial intervention prior to or alongside assisted reproductive techniques for selected infertile men with varicoceles.