Pathogenesis of persistent infertility in men after varicocelectomy

With a view to investigating the cause of persistent infertility, the authors studied a group of 27 patients who had, previously, undergone surgical ligation of the spermatic vein for varicocele and infertility. Of these subjects, who failed to father after surgery, 12 presented persisting varicocele at the clinical examination. In 6 cases, the seminal fluid was positive for U. Urealyticum. One patient had orchiepididymitis; in one spermioagglutinating antibodies were found, in one the female partner was found to be infertile. Even preoperatively, three subjects had pathologically high gonadotropin levels, an important sign of testicular parenchyma alteration. In three subjects only there were no pathological findings to explain persistent infertility.