I've been diagnosed with bilateral varicocele (grade II and III) and my urologist recommended to perform microscopic varicocelectomy after reviewing my test results. I am 32 years old and all of my blood test results (including hormones) were in the normal range, however my semen analysis showed that there are ~34 million sperms out of which 60% are of good motility i.e. ~20 million. My semen analysis from 6 years ago was ~90 million sperm count with 60% motility. I understand that my current sperm count is at the bottom of the normal range. Me and my wife are not planning to have a kids for the next 1-2 years and have not tried yet but my doctor recommends to perform the procedure because there is going to be a difference in the sperm count improvement if he performs the procedure today or if he does it when the sperm count is even lower. I prefer to avoid the surgery if not necessary. I have a few questions:
1- I wanted to verify if this is true. Consider two options: a) Doctor performs the procedure today and b) 2 years from now (if I'm not able to fertilize). Is the sperm count going to be significantly different for these two cases 3 years from now after performing the procedure?
2- Is there a downside with leaving a permanent suture in my body for the rest of my life? What happens to the permanent sutures if the veins shrink or get absorbed by the body? I am not comfortable with leaving an external object (silk in my case) in my body for the rest of my life especially if it causes problems in future and I have to remove it later on. I am a highly active person and play soccer and go to the gym regularly.
3- I'm not sure how experienced the doctor should be for this procedure. My doctor is relatively young and obviously less experienced (urologist for ~4 years). How can I make sure that he is the right doctor to perform the procedure?
I appreciate any help from specialists