Does a Varicocele Always Affect Fertility?

Posted on May 17, 2025 by root

Varicoceles are an often overlooked yet significant concern in male reproductive health. A varicocele is essentially an enlargement of the veins within the scrotum, which can have various implications for fertility and overall male health. As a leading expert in this field, Dr. Justin Houman, a board-certified urologist and fellowship-trained Men’s Sexual and Reproductive Health specialist in Los Angeles, CA, explores what varicoceles are, when they can affect fertility in men and the available treatment options.

What is a Varicocele?

A varicocele occurs when the valves within the veins of the scrotum malfunction, causing blood to pool and the veins to swell. The Urology Care Foundation™ reports that these unpleasant yet common occurrences can be found in nearly 15% of the male population and are especially prevalent among men aged 15 to 25, often developing over time. About 10 to 15 boys out of 100 have a varicocele. It is like getting a varicose vein in your leg.

While most men with varicoceles may not experience any significant symptoms, some may notice discomfort, swelling or a feeling of heaviness in the scrotum.

Do Varicoceles Affect Fertility?

One of the primary concerns surrounding varicoceles is their potential impact on fertility. The National Institutes of Health reports that approximately 40% of men with infertility issues have varicoceles, making them one of the leading causes of male infertility.

The underlying mechanisms include:

• Temperature Regulation: The scrotum is designed to maintain optimal temperatures for sperm production. Varicoceles can elevate scrotal temperature, impairing sperm development and function.
• Hormonal Changes: Varicoceles can lead to hormonal imbalances, particularly in testosterone levels, which play a crucial role in sperm production and male reproductive health.
• Sperm Quality: Research has shown that men with varicoceles often have lower sperm counts and poorer sperm motility, making it more challenging to achieve pregnancy.

The November 2012 Asian Journal of Andrology found that varicoceles are present in 75% of men with secondary infertility.

When Is Treatment Necessary?

Not every varicocele requires treatment. A varicocele may not have any noticeable symptoms or impact on fertility for many men. However, if a couple is experiencing difficulties conceiving, evaluating the presence and severity of a varicocele is essential. Dr. Houman recommends that men undergo an assessment if they:

• Have been diagnosed with infertility.
• Experience discomfort or pain in the scrotal area.
• Notice changes in testicular size or feel a noticeable lump.

In such cases, a consultation with a specialist is crucial for determining the best course of action.

Microsurgical Varicocelectomy in Los Angeles

At Dr. Justin Houman’s practice in Los Angeles, various treatment options for managing varicoceles are available, tailored to meet each patient’s needs. As a minimally invasive microscopic surgeon, Dr. Houman specializes in microsurgical varicocelectomy to help men with fertility issues and other problems caused by varicoceles.

This is the gold standard for treating varicoceles that impact fertility. Through a small incision, Dr. Houman uses a microscope to precisely identify and ligate the affected veins. The June 2023 World Journal of Men’s Health published the findings of a review on a wide array of literature and studies concerning varicocele repair to aid in fertility, and the available research showed significant improvements in all semen parameters after varicocele repair.

Studies published in the January 2010 Journal of Urology® indicate that microsurgical varicocelectomy can significantly improve sperm parameters, with success rates of restoring fertility approaching 50-70%.

Plus, the procedure is:

• Minimally Invasive – Precision technique using a high-powered surgical microscope
• Faster Recovery – Short downtime with minimal post-op discomfort
• Lower Recurrence Rate – Less than 1% recurrence compared to other methods

Other Treatment Options

Other treatments may be recommended if a varicocelectomy is not best for you. These can include:

Embolization

This minimally invasive procedure involves blocking the affected veins using a catheter and coils. The recovery time is shorter than that of surgical options, making it a suitable alternative for some patients.

Hormonal Therapy

If hormone imbalances are a concern, Dr. Houman may recommend hormonal therapies to improve sperm production and overall reproductive health.

Why Choose Dr. Justin Houman?

As a trained expert in Men’s Sexual and Reproductive Health, Dr. Justin Houman has extensive experience diagnosing and treating varicoceles and related fertility issues. Having completed his surgical internship and residency at Cedars-Sinai Medical Center and now serving as a clinical instructor in the Department of Urology, he prioritizes a patient-centered approach, aiming to enhance men’s quality of life through effective hormone management, improving sexual function and helping patients achieve their reproductive goals.

Location matters, and for men in Los Angeles seeking help, consulting with a specialist who understands the unique complexities of varicoceles can be pivotal. Dr. Houman’s comprehensive care ensures that each patient receives personalized attention and the most advanced treatment options.

Assistant Clinical Professor of Urology at Cedars-Sinai Medical Center

Varicoceles can affect fertility, but the extent varies from person to person. The critical takeaway is that if you’re experiencing fertility challenges or notice symptoms of a varicocele, seeking professional advice from an experienced urologist like Dr. Justin Houman in Los Angeles is a significant first step. He is a Board-Certified Urologist and male Fertility Specialist at Cedars-Sinai who offers thorough exams and tailored treatment plans.

Dr. Houman and his team are committed to helping many men find effective solutions to enhance their reproductive health, paving the way for future families. Don’t hesitate to reach out and schedule a consultation to address any concerns. Your health and future are worth it!