Varicocele and Fertility: What Men Should Know

Male infertility can be concerning, but it’s important to know that many contributing conditions are manageable with proper evaluation and care. One common and treatable condition that can affect male fertility is called a varicocele. Understanding what it is, how it affects sperm, and when to seek care can help you take proactive steps toward protecting your reproductive health.

What is a Varicocele?

A varicocele is an enlargement of the veins inside the scrotum (the loose bag of skin that holds the testicles). These veins carry blood away from the testicles. When they don’t function properly, blood can pool in the area, causing the veins to enlarge.

Varicoceles are relatively common, affecting about 15% of men and often developing during puberty or early adulthood. Many men don’t realize they have one unless it’s found during a physical exam or fertility evaluation.

How Varicoceles Can Affect Sperm Health

About 40% of patients experiencing male infertility are found to have a varicocele. A varicocele can impact male fertility in several ways:

• When enlarged veins prevent proper blood drainage, excess heat can build up around the testicles, interfering with the production of testosterone, which can lower sperm count and function
• Poor circulation can lead to oxidative stress and the buildup of toxins, which can damage sperm DNA

Not every varicocele causes fertility problems, but moderate to large varicoceles are more likely to be associated with abnormal semen analysis results.

Treatment Options

Not all varicoceles require treatment. If the varicocele is small and not affecting sperm quality or causing discomfort, your doctor may recommend observation with periodic follow-up. However, your provider may recommend treatment if there is:

• Testicular pain
• Semen analysis shows abnormalities affecting fertility
• Testicular shrinkage

When treatment is recommended, the most common option is a varicocelectomy, a procedure that closes off the affected veins so blood can be redirected through healthier pathways. Improvements in sperm count and motility often occur within 3-6 months after surgery.

In some cases, minimally invasive approaches such as embolization, which block the problematic vein using a catheter, may also be considered depending on anatomy and provider expertise. Your specialist can help determine which option is most appropriate based on your symptoms, fertility goals, and overall health.

How Male Fertility Specialists Can Support You

Hearing that something may be affecting your fertility can be stressful, but varicoceles are one of the most treatable causes of male infertility. Many men see meaningful improvements in semen parameters after treatment, and some couples are able to conceive naturally afterward. If you have concerns about fertility or scrotal discomfort, our reproductive urologists can perform a physical exam and recommend appropriate testing. Addressing possible male-factor issues sooner rather than later can help you avoid delays as you plan for the future. Reach out today to learn more.