Reassessing the Role of Subclinical Varicocele in Infertile Men With Impaired Semen Quality: A Prospective Study

ObjectiveTo evaluate the seminal, hormonal, and spontaneous pregnancy outcome after percutaneous embolization of the internal spermatic vein in infertile men with left-sided subclinical varicocele and one or more abnormal semen parameters.MethodsA total of 218 patients underwent percutaneous embolization, and 119 patients were included as the observation group. All patients were followed up prospectively for 39.4 ± 6.5 months. Semen parameters and hormonal levels were evaluated before any procedure and 6 months after.ResultsSignificant improvement in the mean sperm concentration, total motility, and lower follicle-stimulating hormone levels was noted in those who underwent varicocele embolization as compared with those not treated. After 39.4 ± 6.5 months, pregnancy rates were 46.3% for the treated group and 11.8% for the control group (P = .011).ConclusionIn infertile men, small varicoceles, even subclinical ones, should be identified and treated.