Cost-Effectiveness Analysis of Varicocele Repair and Assisted Reproductive Technology

  • Darren J. Bryk
  • Sarah C. VijEmail author


The association between varicocele and male infertility is well-established, although the exact mechanism by which varicoceles cause infertility in men is debated. Surgical correction of varicoceles in men with infertility and abnormal semen parameters has been shown to improve semen parameters in most men. Over the last few decades, assisted reproductive technology (ART), most notably, intracytoplasmic sperm injection (ICSI), has become a highly utilized approach to achieve pregnancy for couples with infertility. With ART options available to many couples, one must consider the most cost-effective mode of achieving pregnancy in infertile couples. This chapter examines the relationship of varicocelectomy and ART from the cost perspective. Infertile men who undergo varicocelectomy are often candidates for less invasive and less costly forms of ART. Moreover, for those men who still require ICSI after varicocele repair, the pregnancy and live birth rates are improved compared to men who use ICSI without varicocele repair. Lastly, varicocelectomy in men with varicocele-associated infertility is more cost-effective than proceeding directly to ART for infertility management.


Varicocelectomy Varicocele repair Varicocele-associated infertility Assisted reproductive technology Intracytoplasmic sperm injection Cost-effectiveness 


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Cleveland Clinic FoundationGlickman Urological and Kidney InstituteClevelandUSA

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