Influence of varicocele embolization on the choice of infertility treatment.

OBJECTIVE

To investigate whether embolization of a varicocele improves semen quality and enables use of less-invasive modes of assisted reproductive technology (ART) in infertile men with a physically palpable varicocele confirmed by phlebography.

DESIGN

Retrospective chart review.

SETTING

University infertility clinic.

PATIENT(S): Fifty patients with varicoceles that were treated with embolization and 11 patients with untreated varicoceles (control group). In both groups the clinical varicoceles had been phlebographically confirmed.

INTERVENTION(S): Phlebography and embolization.

MAIN OUTCOME MEASURE(S): Semen characteristics and mode of ART before and after treatment.

RESULT(S): Median improvements of semen parameters, such as concentration and motility after processing, were significantly greater in the embolization group than in the untreated group. In the embolization group, semen samples improved to levels requiring less-invasive modes of ART in significantly more patients than in the untreated group. Deterioration of semen samples, requiring more invasive techniques, was significantly more frequent in the untreated group than in the embolization group.

CONCLUSION(S): Embolization of a varicocele in infertile men significantly improved semen, such that much more often a less-invasive form of ART than was planned before treatment became feasible. Embolization of a varicocele might even prevent further deterioration of semen samples to levels requiring more-invasive ART.