Varicocele

The primary function of the testis is to produce sperms and also secrete hormones to regulate the production of sperms and the male sex hormones. A person who is castrated before attaining puberty fails to develop male characteristics due to lack of the hormones.

Normally the testis hangs below the body so that its temperature is lower by 3 to 4^° Celsius. This helps in the process of sperm production. When there are dilated veins there is stagnation of blood in the scrotal sac and this causes elevation in the temperature of the hanging sac. This can cause drop in the sperm production and the motility of the sperms. However for this to happen the varicocele should be gross and be appreciable clinically. It has been estimated that 40% of sub-fertile men suffer from varicocele. One must remember that varicocele is not the only cause for low sperm count and other causes should be excluded before making this conclusion.

The surgical treatment of varicocele for low sperm count or altered morphology has been controversial.

Some noteworthy points on varicocele surgery and fertility facts include -

Varicocele with low sperm count that are not visible clinically and can be picked up only by ultrasound, if operated upon with the purpose of improving the counts is seldom likely to succeed. In a similar low count situation with a clinically apparent varicocele, the correction of the varicocele corrects the reduced sperm count and sperm morphology. There are many publications on this subject in the literature to support the surgery for this purpose.