Varicocele and fertility. Treatment tactics. Review of the literature
Artak Madatyan
YSMU, Department of Urology and Andrology,
MC “Fertility Center”
Abstract
The conclusion from personal observations, based on the fact that the average period of spontaneous pregnancy after varicoceleectomy occurring is between 6-12 months, for patients with varicocele and oligoasthenospermia who are preparing for conception using assisted reproductive technologies, I recommend performing varicoceleectomy in parallel with ART, contributing to the improvement of spermogram abnormalities for further spontaneous pregnancy. For several decades now, the need to treat varicocele has been the subject of debate. A controlled randomized trial showed that surgical treatment of subclinical varicocele does not increase the likelihood of natural conception. A meta-analysis of prospective randomized and non-randomized studies has shown that surgical treatment of men with normal spermogram parameters compared with patients under supervision does not improve spermogram data, that is, preventive varicocelectomy does not prevent deterioration of sperm parameters. Studies that included patients with abnormal spermogram parameters showed that after treatment with varicocele, the probability of natural conception and the number of spermatozoa increased significantly compared with patients in the control group.