Male Infertility Treatment Skips Surgery

Varicocele Treatment May Reduce Need for Surgery or in Vitro Fertilization

Medically Reviewed by Brunilda Nazario, MD on July 22, 2008
From the WebMD Archives

July 22, 2008 -- A new treatment for a cause of male infertility may reduce the need for surgery while increasing couples' chances of becoming pregnant.

Researchers say varicoceles, a tangled network of dilated or varicose veins in the scrotum, affect 10% to 15% of otherwise healthy men. Varicoceles can interfere with sperm function and male fertility. How and why this condition might cause fertility problems in men remain unknown. The traditional treatment for this condition has been open surgery, but a new study shows a minimally invasive outpatient procedure was successful in treating 226 out of 228 varicoceles associated with male infertility.

"Venous embolization, a simple treatment using a catheter through the groin, can help to improve sperm function in infertile men," researcher Sebastian Flacke, MD, PhD, now associate professor of radiology at the Tufts University School of Medicine, says in a news release. "With the patients' improved sperm function, more than one-quarter of their healthy partners were able to become pregnant."

In the treatment, a radiologist inserts a small catheter through a small incision in the groin and uses an imaging tool to guide it to the affected right- or left-sided varicocele. Recovery time is minimal, and researchers say most patients can return to work the next day.

Nonsurgical Option for Male Infertility

In the study, published in Radiology, researchers evaluated the catheter-guided embolization male infertility treatment in 223 men aged 18-50 with at least one varicocele. All of the men had healthy partners and were trying to become pregnant.

The results showed 226 of the patients' 228 varicoceles were successfully treated with embolization. Researchers performed semen analysis on 173 of the men three months after treatment and found sperm activity (motility) and sperm count had significantly improved. Six months later, 45 couples or 26% had successfully become pregnant.

Researchers found a high level of sperm motility prior to varicocele treatment was the most significant factor related to achieving pregnancy.

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Flacke, S. Radiology, August 2008; vol 248: pp 540-549.

News release, Radiological Society of North America.

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