Abstract
Varicoceles are a common finding implicated in male subfertility. These dilated veins of the pampiniform complex are thought to alter the physiology and testicular microenvironment, thus leading to potential testicular dysfunction. While the effect of varicoceles on the testis is well-established, management is not. It is important to be cognizant that while varicoceles only affect the male partner, infertility as a whole involves both the male and female. This complex interplay of the health and well-being of two individuals is challenging. Guidance and management can be particularly challenging when the female partner is of advanced maternal age.
This chapter will address the unique challenges of managing a patient with known varicocele and severe semen abnormalities, in the setting of a female partner who is 36 years of age or greater. We will review the pathophysiology and options for intervention. We will then examine the effect that any intervention may have on assisted reproductive technology (ART) utilized by the partner. This includes intrauterine insemination (IUI) and in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI). Finally, we will discuss how to optimize management of these patients and provide care that matches their goals and expectations.
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Smith-Harrison, L.I., Sandlow, J.I. (2019). Clinical Varicocele and Severely Abnormal Semen Analysis in a Couple Considering ART Whose Female Partner Is Over 36 Years Old. In: Esteves, S., Cho, CL., Majzoub, A., Agarwal, A. (eds) Varicocele and Male Infertility. Springer, Cham. https://doi.org/10.1007/978-3-319-79102-9_50
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DOI: https://doi.org/10.1007/978-3-319-79102-9_50
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