Why Is It That Not All Men with Varicocele Are Infertile?

  • Ramy Abou GhaydaEmail author
  • Martin Kathrins


Varicocele has been linked to male infertility for a long time. The majority of the scientific community has assumed that varicocele has a detrimental effect on male fertility based on a vast number of scientific evidence. However, the evidence is often criticized due to several flaws in the methods, studied population, reported outcomes, and strengths of conclusions and clinical recommendations. Many papers have challenged the assumed causality effect of varicocele on male infertility at the pathophysiological levels and clinical significance of the outcomes. Indeed, many men with varicocele retain their fertility potential. It has been shown that the presence of varicocele negatively affects fertility only on a subgroup of susceptible or predisposed men. Thus, varicocele might not be the sole cause for male infertility. New technological advancements, such as proteomic studies or biological markers, might provide insights towards further evaluation of men with varicocele and direct their therapeutic management.


Varicocele Male factor infertility Pregnancy outcomes Varicocele epidemiology Proteomic markers Inhibin B sperm apoptosis Varicocelectomy Oxidative stress Sperm DNA integrity 


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© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of UrologyBrigham and Women’s HospitalBostonUSA
  2. 2.Department of UrologyBrigham and Women’s Hospital/Harvard Medical SchoolBostonUSA

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