Varicocelectomy in the subfertile male: a ten-year experience with 295 cases

During a 10-year period 295 varicocelectomies were performed in subfertile males. Results of follow-up studies indicate the following: (1) Semen quality improved in a meaningful manner in 58% of men following varicocelectomy. The improvement, except at times for motility, was often only modest. The semen improved in 46% of men with a preoperative average count of less than 10 million/ml and in 70% whose count was 10 million/ml or more. (2) The stress pattern of sperm morphology was seen prior to surgery in 93% of the men. (3) The pregnancy rate for the entire series was about 41%. Men with a preoperative count of 10 million/ml or more achieved a 48% conception rate and those with a count of less than 10 million/ml succeeded 35% of the time. Only 7% of the pregnancies occurred without a concomitant improvement in the semen quality. (4) Men with moderate- and large-sized left varicoceles fared better than those with small-sized varicoceles. (5) Varicocelectomy, when varicocele and poor semen quality coexist, is a justified procedure in the treatment of the infertile couple.