Insemination data on men with varicoceles.

OBJECTIVE

To determine possible benefits of sperm processing and intrauterine insemination (IUI) for a group of men with a varicocele history who had not achieved a pregnancy by natural coitus (mean duration of infertility 42.2 months).

DESIGN

A retrospective study including infertile men with varicoceles who were classified by their semen analyses and sperm penetration assays (SPAs).

SETTING

Private practice of infertility.

PATIENTS

Seventy-one infertile couples. The husbands had a varicocele history and were grouped into four clinical categories (14 untreated, 5 medical treatment, 34 varicocelectomies, and 18 varicocelectomies plus medical treatment). The wives were studied or treated before IUI.

INTERVENTIONS

Varicocelectomies were performed on the males when indicated. Female studies included laparoscopies as indicated intrauterine insemination with Tomcat catheter (Sherwood Medical, St. Louis, MO) was performed in all cases.

MAIN OUTCOME MEASURES

Overall pregnancy rates (PRs) and fecundity rates with sperm processing and IUI.

RESULTS

Six pregnancies occurred with 66 cycles of sperm processing and IUI among 28 men with normal SPAs (PR 21%, fecundity rate = 0.09). In contrast, there were no pregnancies with 121 cycles among 43 varicocele patients with abnormal SPA results or with low values for all three semen parameters.

CONCLUSIONS

Sperm processing and IUI may be beneficial for selected patients with varicoceles who had not achieved a pregnancy by coitus.