The outcome of varicocelectomy in subfertile men with an absent or atrophic right testis

To determine the effects of varicocelectomy on semen quality, testicular volumes and serum hormone levels in subfertile men with an absent or atrophic right testis.

Seventeen patients whose wives were gynaecologically normal were evaluated with at least two semen analyses and measurements of serum hormone levels and antisperm antibodies. Scrotal ultrasonography was used to determine testicular volumes and spermatic vein diameters. Varicocelectomy was performed by high ligation via an inguinal approach. All patients were seen at a follow-up 3 months later, and after 6, 9 and 12 months the scrotal ultrasonography, hormone assessment and semen analyses were repeated. Any pregnancies in their wives were recorded over a median follow-up of 19 months.

After surgery, all patients had significant improvements in sperm motility, morphology and concentration (P<0.01) but the differences in pre- and post-operative testicular volumes and plasma hormone levels were not statistically significant (P>0.01). No patients had immunological infertility. Eleven of the wives became pregnant during the follow-up.

Higher pregnancy rates can be achieved by left varicocelectomy in subfertile men with an absent or atrophic right testis. Sperm concentration, motility and morphology are significantly improved by varicocelectomy.