low semen counts in 24 year old boy.-please help

My 24 year son is suffering from mild verecocele on both the testis. He has been taking medicine for psychitric problem for the last two years. Doctor is hsitating to operate his vericocele saying that he may become weak on accountof operation. His semen count is going down day by day. The recent test shows that he is having 6 million semen count. I could not understan the reasons of low count. Even the doctor could not tell any thing so far. He is little obess. He is depressed on account of his studies and job prolems. He complains unexplained pain in scrotal area. He says that he feels pain on the back side of his scrutal. The pain will be more when standing or sitting for long. The vericocele was not visible at the beginning. Now on careful examination it is detected on scanning. What should I do for him. How to get rid of this verococele. Can he get married soon. How can he increase his semen count. Is the operation os must. Is there any alternative therapy available which cures vercocele. Kindly help

[Elaine Brown, MD]

Hi!
You may also want to post your question in the urology forum, as those are the doctors who perform the surgery. If your son was my patient, I would definitely want to do some blood testing/hormone levels to see if the medications he is taking are affecting his sperm count.  The only way I know to "cure" a varicoceole is with surgery.  The question is whether the operation would work, as the results are very controversial.
If your son was my patient, I would want to try everything else first, including trying for awhile to conceive once he is married.
Good luck!
Dr B