Varicocelectomy before assisted reproductive technology: are outcomes improved?
Compared with men with uncorrected varicocele, correction of a clinical varicocele improves pregnancy rates for azoospermic and oligospermic men undergoing in vitro fertilization/intracytoplasmic sperm injection, but does not improve intrauterine insemination pregnancy rates.
Volume 108, Issue 3, Pages 385–391
Taylor P. Kohn, M.Phil., Jaden R. Kohn, B.S., Alexander W. Pastuszak, M.D., Ph.D.
Clinical varicoceles have been associated with impaired semen parameters and male-factor infertility. Varicocele repair can improve live birth rates for men with clinical varicocele. Varicocelectomy is often combined with assisted reproductive techniques (ART) such as intrauterine insemination (IUI), in vitro fertilization (IVF), or intracytoplasmic sperm injection (ICSI). Here we review the literature examining varicocelectomy before ART to evaluate whether improved pregnancy outcomes are realized. Although insufficient evidence exists to determine if correcting a varicocele improves IUI outcomes, a clinical benefit is observed when correcting a clinical varicocele in oligospermic and nonobstructed azoospermic men before IVF/ICSI. In couples seeking fertility with the use of ART, varicocele repair may offer improvement in semen parameters and may decrease the level of ART needed to achieve successful pregnancy.