The great debate: varicocele treatment and impact on fertility

Objective: To evaluate the current literature on the impact and potential mechanisms of varicocele repair on male fertility. Design: Pertinent articles were identified through computer PubMed search on varicocele repair and male factor infertility. References of selected articles were hand searched for additional citations. Conclusion(s): Varicocele repair has been shown to reverse a spectrum of effects contributing to men with impaired fertility. Clinical studies on the intervention have illustrated variable effects on postoperative sperm parameters and pregnancy rates (PR). Studies with conflicting results suffer from a significant number of confounding variables such as variable repair technique or lack of controls. Additional studies are warranted on the role of modern microsurgical varicocelectomy given the improvements in assisted reproductive technologies (ART). (Fertil Steril (R) 2011; 95: 841-52. (C) 2011 by American Society for Reproductive Medicine.)