Bilateral Varicocelectomy complications

I am a 30 years old guy. Actually since 2005 I was noticing some dried gum type(semi solid) small pieces in my semen so I consulted to a Urologist in Bangalore in Feb 2006. He had my semen analysis done which came out as very low sperm count 16 millions/ml with 65% Vitality & 5% Rapid Progression (2ndFeb'06)so he asked me for Scrotal Doppler test which said that I have some dilated veins which shows reflux during valsalva's manoeuvre. So he suggested a Bilateral Varicoelectomy surgery to remove those dilated veins. After surgery I again had sperm analysis done in following dates to see the improvement in count:
1) 15 millions/ml , 70% Vitality, 5% Rapid Progression (14th May'06)  
2) 17.5 millions/ml, 75% Vit, 15% RP (30th Jun'06)
3) 28.8 millions/ml, 80% Vit, 15 % RP (8th Sep'06)
4) 34 millions/ml, 75% Vit, 10% RP (3rd Feb'07)
5) 80 millions/ml, 80% Vit, 25% RP (21st Apr'07)
6) 32 millions/ml, 75% Vit, 30% RP (1st Oct'07)
Since my sperm count was still not as much as I expected so I took cold water therapy (drench both the testicles with cold water for 15 mins) after my 2nd semen analysis mentioned above and also I took Fertyl pills (dont knw exact name) for 3-4 months to increase the count but I couldn't see any drastic change in my count.
I am summarizing here my post operation complications which I am still facing even after almost 2.5 yrs of surgery.
1)Low count
2)Semen is not at all thick (most of the time just like water) as it was before
operation. I can see thickness only if abstain from sex for 4-5 days.
3)Semen quantity is not much as it was earlier. Not more than 1 or 2 ml.
4) Pain in my penis right after ejaculation once in a while.
5)Mild pain or say sensation in the left waist region after ejacualtion where I got a cut for operation.

I again had a Scrotal doppler test in Oct 2007 which says "Mild reflux noted on Valsalva in pampaniform plexus". My Urologist says its ok. Will this semen analysis is sufficient to concieve (conceive) a baby.

[Elaine Brown, MD]

Hi!
Hey--it only takes one sperm and you have 15 million!  I don't mean to make light of your situation, but you have reasonably good chances, and lots of options.

Clomid is one medication that I have seen work to increase sperm count.  I don't know if that is what you were taking.  Proxede is available on the internet without a prescription, and seems to have some benefits.

If you are ready for a baby right now, I would suggest considering Intra Uterine Insemination.  This  is easily done and not terribly expensive.  At my office it would run about $400-500 US. or less.

If I were you, I would avoid further surgery, as it is unclear whether there is a true benefit from varicoceolectomy, although it is often done.

You would also have the option to go for ICSI (intra-cytoplasmic sperm injection) This is an In vitro procedure in which a sperm is injected directly into an egg.  It works very well, although it is expensive and time consuming.  With a  young wife, you might get as many as 20 embryos from one procedure--which could be frozen and transferred later as you desired more children.

Now a days fertility is a very different game! So you have a very good chance if you save up your money!

Good luck!
Dr B