Con: Should Varicocele Be Repaired in Azoospermic Infertile Men?
The impact of varicoceles on male fertility status and the effect of varicocele repair in improving reproductive outcomes have long been a subject of controversy in male reproductive medicine. The current opinion held by experts representing various professional societies is that varicocele repair could lead to an overall improvement in male fertility status. The varicocele controversy has also sparked up a debate related specifically to a subgroup of men with non-obstructive azoospermia (NOA) on whether repair of clinical varicoceles could also lead to improvement in male fertility status that can ultimately lead to improved reproductive outcomes particularly in the context of assisted reproduction. In this debate, we will present our view, based on available evidence in the current literature, that varicocele repair should not be routinely performed in all men with NOA and clinical varicoceles. Clinicians are advised to be informed on the arguments from both sides of this important debate so that they can better formulate appropriate counselling strategies to infertile couples facing these common male factor infertility diagnoses.
KeywordsNon-obstructive azoospermia Varicocele Varicocele repair Debate Male infertility Varicocelectomy Micro-TESE ICSI Reproductive outcomes
The contents and the opinions presented in this chapter are for the purposes of academic exchange and education only and should not be used in isolation for any clinical decision making without a proper consultation with qualified healthcare professionals.
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