Pro: Should Varicocele Be Repaired in Azoospermic Infertile Men?

  • Sandro C. EstevesEmail author


The coexistence of palpable varicocele and nonobstructive azoospermia has led urologists to offer varicocele repair as a means to improve reproductive outcomes for men with spermatogenic failure seeking fertility. In this chapter, we critically discuss the existing evidence concerning the potential beneficial effect of varicocele repair on selected men with NOA and spermatogenic failure. We also examine the prognostic factors affecting postoperative outcomes to help clinicians best identify those candidates for varicocele repair. Providing care for infertile men with nonobstructive azoospermia, including those with varicocele, involves a coordinated multi-professional effort. Clinicians should judiciously examine the existing evidence and discuss with their patients with NOA and concomitant varicocele the possibility of improvement in reproductive outcomes by varicocele repair. Offering varicocele repair to selected men with NOA is valid and sound provided that the advantages and limitations of the intervention have been made clear to the patient.


Varicocele Nonobstructive azoospermia Varicocele repair Male infertility Varicocelectomy Sperm retrieval Intracytoplasmic sperm injection Assisted reproductive technology Pregnancy Reproductive outcomes 


Conflict of Interest

The author has nothing to disclose.


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.ANDROFERTAndrology & Human Reproduction ClinicCampinasBrazil

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