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Urology (Expert Forum)
Varicoceles
Answered by
Kevin Pho, MD - Internal Medicine
Kevin Pho, MD
Boston - MA
Questions in the Urology forum are answered by Dr. Stephen Liroff, affiliated with the Henry Ford Hospital. Topics covered include benign prostate disease, penis curvature, cystisis, kidney stones, pediatric urology, prostate, sexual dysfunction, urinary tract infections (UTI), and urological cancers.
Varicoceles
by Macke, Mar 15, 2004 12:00AM
I am 31 and have had a varicocele in my left testicle for about thirteen years. It causes some minor discomfort and pain every once in a while but it is not a major problem. However, I am concerned about potential infertility issues since I plan on getting married within the next year or two. Should I try to treat this now by seeing a specialist and having sperm count tests done and/or look into treatment options or should I wait to see if attempts at pregnancy fail some time in the future?
Also, how reliable are home fertility tests? I tried one called FertilMarq and it appears as though the test indicates I have a low sperm count. However, when I took the test I only waited one day since the last time I ejaculated. I did not realize that the directions for the test say that you should not ejaculate for three days before taking the test. Does waiting three days instead of one day improve the number of sperm?
Overall, how concerned about this varicocele should I be? Since I've read that up to 40% of male infertility problems are caused by vericocele, I'm not feeling too positive.
Also, how reliable are home fertility tests? I tried one called FertilMarq and it appears as though the test indicates I have a low sperm count. However, when I took the test I only waited one day since the last time I ejaculated. I did not realize that the directions for the test say that you should not ejaculate for three days before taking the test. Does waiting three days instead of one day improve the number of sperm?
Overall, how concerned about this varicocele should I be? Since I've read that up to 40% of male infertility problems are caused by vericocele, I'm not feeling too positive.
Doctor's Answer
by Kevin Pho, MD, Mar 16, 2004 12:00AM
, Mar 16, 2004 12:00AM
The relationship between varicoceles and infertility remain unclear. Some studies show a clear relationship, but in many cases the sperm sample is normal.
There are no clear guidelines regarding the treatment of a varicocele. However, it is recommended that treatment with surgical ligation be considered if fertility is a concern. I would have this evaluated by a urologist.
The more accurate test would be a sperm sample analyzed at your urologist's office. The semen sample should be collected after two to seven days of sexual abstinence, preferably at the doctor's office by masturbation.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Thanks,
Kevin, M.D.
There are no clear guidelines regarding the treatment of a varicocele. However, it is recommended that treatment with surgical ligation be considered if fertility is a concern. I would have this evaluated by a urologist.
The more accurate test would be a sperm sample analyzed at your urologist's office. The semen sample should be collected after two to seven days of sexual abstinence, preferably at the doctor's office by masturbation.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Thanks,
Kevin, M.D.