The significance of microsurgical varicocelectomy in the treatment of subclinical varicocele

ObjectiveTo assess the improvement of seminal characteristics and pregnancy rates after microsurgical varicocelectomy in men with subclinical varicocele.DesignRetrospective study.SettingUniversity infertility clinic.Patient(s)One hundred forty-three patients with a subclinical left-sided varicocele.Intervention(s)Patients who agreed to microsurgical varicocelectomy (n = 25, surgery group), medical treatment with L-carnitine (n = 93 drug group), and those who did not agree to any treatment (n = 25, observation group) were enrolled.Main Outcome Measure(s)Semen characteristics were reevaluated twice 6 months after treatment. The natural pregnancy rates were estimated by telephone interview between 1 and 2 years after treatment.Result(s)In the surgery group, sperm counts improved significantly after microsurgical varicocelectomy. In the drug group, however, sperm parameters did not significantly improve after treatment. Natural pregnancy rates were 60.0% in the surgery group, 34.5% in the drug group, and 18.7% in the observation group. The natural pregnancy rate of the surgery group was higher than the other groups, and there were statistically significant differences among the three groups.Conclusion(s)Surgical treatment is the best option for management of subclinical varicocele.