Update on treatment of varicocele: counselling as effective as occlusion of the vena spermatica.

This prospective randomized study was performed in order to investigate the effects of interventive treatment or counselling on pregnancy rates in infertile couples in whose male partners a varicocele was diagnosed. The present report extends a previous study using the same design. A total of 125 couples were included in the current study while the previous report comprised 95 couples. Couples fulfilling the inclusion criteria were allocated randomly either to interventive treatment (surgical ligation or angiographic embolization of the spermatic vein) (n = 62) or to counselling as the sole treatment (n = 63). Couples were followed over the subsequent 12 months and seen at 3-monthly intervals. At the end of the 12 month period pregnancy rates, as the main outcome measure, were 29% in the group given interventive treatment and 25.4% in the counselled group and were not significantly different. The only significant difference found, regardless of treatment modality, was the wives' age at admittance: the 34 wives achieving a pregnancy were 28.8 +/- 0.6 years (mean +/- SE) old while the 91 non-pregnant wives were 31.2 +/- 0.3 years old (P < 0.05). The study suggests that regular counselling of the infertile couples is as effective as interventive treatment of varicoceles in achieving pregnancies.