A follow-up study of semen quality and fertility in men with varicocele testis and in control subjects.

OBJECTIVE

To evaluate semen quality and fecundity in a group of men with initially untreated varicocele testis, in comparison with control subjects.

PATIENTS, SUBJECTS AND METHODS: In a prospective, longitudinal study, 77 men (39 with varicocele and 38 control subjects) were evaluated in 1989 and re-investigated after 8 years. Fifty-seven men (29 with varicocele, 28 controls) were available for evaluation and they all completed a questionnaire. Semen from a total of 46 men (24 with varicocele) was compared with findings in 22 men from the control group.

RESULTS

There was a decline in sperm count in the control group from 80 x 10(6)/mL to 55 x 10(6)/mL over the 8-year period, but nearly no change in the sperm count in the men with varicocele. The withdrawal rate from each group was the same and included both men with and without reduced semen quality. There were no differences between the groups in sperm motility values (straight-line velocity, curvilinear velocity) evaluated using computer-assisted semen analysis. Paternity was achieved by 10 of 14 men in the varicocele group, compared with 14 of 16 in the control group.

CONCLUSIONS

There was no evidence that varicocelectomy might benefit patients, because the sperm concentration did not decline among men with varicocele over time. Computer-assisted semen analysis provided a good assessment of various sperm motility characteristics and we recommend evaluation using such objective methods, to allow comparison among studies