Grade 1 Varicocele and Borderline/Normal Conventional Semen Analysis
The condition known as varicocele has been described for centuries. Literature defines varicocele as a cause of infertility for 50% of cases of male component. Today, there is a discrete agreement regarding the need for intervention in case of high-grade varicocele with marked seminal alterations while the management of low-grade varicocele with modest changes in the sperm is still debated. The main problem is therefore to define what to do when we are facing a patient who has a modest alteration of the semen analysis.
In this chapter, we focus on the diagnostic methods for varicocele and the clinical management of patients with grade 1 varicocele and borderline/normal conventional semen analysis. We performed a literature review and integrated it with our personal experience.
KeywordsVaricocele Doppler ultrasound Infertility Sperm count Sperm analyses
- 4.Bennet WH. Varicocele, particularly with reference to its radical cure. Lancet. 1889;i:261–3.Google Scholar
- 5.Damsgaard J, Joensen UN, Carlsen E, Erenpreiss J, Blomberg Jensen M, Matulevicius V, Zilaitiene B, Olesen IA, Perheentupa A, Punab M, Salzbrunn A, Toppari J, Virtanen HE, Juul A, Skakkebæk NE, Jørgensen N. Varicocele is associated with impaired semen quality and reproductive hormone levels: a study of 7035 Healthy Young Men from Six European Countries. Eur Urol. 2016;70(6):1019–29. https://doi.org/10.1016/j.eururo.2016.06.044. Epub 2016 Jul 14.CrossRefGoogle Scholar
- 11.Miyaoka R, Sandro C. Esteves a critical appraisal on the role of Varicocele in male infertility. Adv Urol. 2012:597495. 9 pages.Google Scholar
- 16.Pontonnier F, Mansat A, Mieusset R, Malonga G, Gautier JR, Ioualalen A. Varicocelectomy for infertility is more effective in cases of sperm count less than 5 million/ml. Apropos of 70 cases. Ann Urol (Paris). 1986;20(4):249–51.Google Scholar
- 17.Jonathan PJ. Effects of varicocele on male fertility. Hum Reprod Update. 2001;7(1):59±64.Google Scholar
- 20.Verhovsky G, Neheman A, Rappaport YH, Kedem R, Hofman A, Zisman A, Haifler M. Varicocele management strategies and resulting paternity rates in a cohort of young adults. Urology. 2018:S0090–4295(18)30389–3.Google Scholar
- 21.WHO laboratory manual for the examination and processing of human semen. 5th ed: World Health Organisation.Google Scholar