Varicocele: Its Role in Male Infertility

Abstract

The relationship between infertility and presence of a varicocele has been argued by many investigators over the last century (Tulloch 1952; Russell 1954; Ivanissevich 1960; MacLeod 1965; Amelar et al. 1977). A varicocele was first documented by Celsus in the first century A.D. when he described the condition and reported that “the testicle of varicocele is smaller than the unaffected side”. He also described a surgical procedure for the treatment of varicocele (Hotchkiss 1970). The first cause and effect association between a varicocele and infertility was described by Barfield before the turn of the century, but it was not until 1952 when Tulloch reported a case of varicocele ligation with resultant pregnancy that the association was verified. Since then, numerous series have suggested that the presence of a varicocele could result in lower fertility rates (Scott and Young 1962; Brown et al. 1968; Dubin and Amelar 1977). Most investigators have accepted the relationship between varicocele and male subfertility, but recent challenges suggest that we re-evaluate the entire subject (Rodriguez-Rigau et al. 1978).