Male Fertility: What is a Varicocele?
Varicocele is a condition where blood pools in the veins of the scrotum, leading to an enlargement of the venous plexus. This condition is quite common, with up to 43% of adult males being affected. Interestingly, men with varicoceles are more likely to experience infertility, with up to 80% of men with secondary infertility having varicoceles.
There is no established cause for varicocele, but it is likely to be a combination of factors. Proposed mechanisms for this condition include hypoxia and stasis (impaired drainage or pooling of blood around the testicles), testicular venous hypertension, elevated testicular temperature, an increase in spermatic vein catecholamine leading to testicular under-perfusion and increased oxidative stress. These mechanisms can lead to germ cell apoptosis and subsequent oligospermia, which is a condition where there is a low sperm count. Additionally, varicocele can lead to hypoxia on the Leydig cells, which can result in reduced levels of androgens, as well as reactive oxygen species (ROS)-induced DNA integrity problems.
One of the main problems with varicoceles is that they cause a disruption of the blood-testicular barrier and can cause an autoimmune status. This can lead to damage to the seminiferous tubules and an increase in germ cell apoptosis. As a result, the quality and quantity of sperm produced may be negatively affected, leading to difficulties in conceiving.
If you are experiencing symptoms of varicocele, such as a visible or palpable lump in your scrotum or pain, it is important to seek medical attention. Treatment options are available and may include lifestyle changes, such as weight loss, acupuncture, engaging in regular physical activity, as well as surgical interventions such as open microsurgical inguinal or subinguinal techniques. These treatments may help to improve fertility outcomes and increase the chances of conceiving.
