Evaluation and Surgical Management of Varicocele in Infertility Treatment with Assisted Reproductive Technology: A Case Report.

This case study reports a couple presenting with primary infertility, the female partner aged 34 and the male partner aged 37. All investigations for the female revealed normal reproductive function, while the male was diagnosed with severe oligoasthenozoospermia and varicocele. After a microsurgical varicocelectomy failed to improve semen parameters, testicular sperm extraction (TESE) procedures, including testicular sperm aspiration (TESA) and micro-TESE, were employed. Despite limited success in retrieving viable sperm, five mature oocytes from the female partner were fertilized via intracytoplasmic sperm injection (ICSI) using motile spermatozoa treated with theophylline. Two blastocysts were successfully cultured and cryopreserved. A frozen embryo transfer (FET) was performed two months later, leading to the implantation of the embryos. This case highlights the challenges of male factor infertility associated with varicocele, the limited improvement in semen parameters following surgery, and the successful use of advanced ART techniques, including micro-TESE and ICSI, in achieving fertilization and embryo development. This case shows a sequential application of surgical, medical, and ART approaches to overcome severe male infertility when conventional treatments do not achieve the desired results.