Varicocele: To Treat or Not to Treat?

Varicocele treatment in infertility still remains controversial. It is clear, in fact, that in many patients, varicocele has no impact on fertility. Recent scientific evidence demonstrated that varicocele treatment is beneficial in improving semen parameters and pregnancy rate when an appropriate selection of patients is made. The purpose of treating varicocele in adults is mainly to improve current fertility status. On the other hand, the goal of treatment in adolescents is to prevent testicular injury and maintain testicular function for future fertility. Hence, the key to the success of varicocele treatment seems to be a correct indication. The aim of this study is to review and summarize current evidence in managing varicocele treatment focusing on the controversies regarding surgical indications in adolescent and adult patients, and in other specific situations such as azoospermia, bilateral or subclinical varicocele, and prior to ART.

Automated summary

The treatment of varicocele in infertility is still a controversial issue. Recent scientific evidence shows that varicocele treatment can improve semen parameters and pregnancy rates. The aim of treatment in adults is to improve current fertility status, while in adolescents, it is to prevent testicular injury and maintain future fertility. Correct indication seems to be the key to successful varicocele treatment. This study reviews and summarizes the current evidence on varicocele treatment, focusing on surgical indications in adolescents and adults, as well as other specific situations.