What is a varicocele and how does it affect your Fertility?

Last updated on March 6th, 2023 at 07:23 am

5 minutes read.  

  

In this article:

What’s Varicocele?

Causes , Diagnosis

Symptoms , Prevention

Varicoceles and Infertility

Living with , FAQ

Conclusion

What’s Varicocele?

A varicocele is an abnormal dilatation and tortuosity of the veins of the spermatic cord.

Although varicoceles are common in the general population and are frequently found on routine physical examinations, they represent the most common correctable cause of male factor infertility. (1)

In simple terms, varicoceles (swollen veins in your scrotum) usually cause mild or no symptoms. You may not need treatment. It’s a common cause of male infertility. Surgery to repair a varicocele may offer some people more reproductive options.

Varicoceles are a common disorder of the veins inside your scrotum, the protective sac that protects and holds your testicles (balls). If you have a varicocele, it means veins inside your scrotum are enlarged (wider than they should be).

Varicoceles are similar to varicose veins, a common condition that causes veins in your leg to swell and lose their shape.

Varicoceles are usually painless but can sometimes cause aching testicles or pain that may come and go. In some people, a varicocele can affect fertility. If a varicocele doesn’t bother you, you may not need treatment. (2, 3, 4 )

Causes

What causes varicoceles?

Much remains unknown about why varicoceles develop. It may be that varicoceles occur due to a faulty “switch” (or valve) inside certain veins in the spermatic cord, a band of tissues that holds your testicles in place.

These veins move blood from your testicles to the rest of your body. The valve acts as an “on/off switch.” When a valve doesn’t work the way it should, excess blood may build up inside testicular veins. Over time, this malfunction causes veins to swell. (5, 6, 7 )

What are the symptoms of varicoceles?

A varicocele often causes no symptoms. You may notice:

• Dull testicular pain or scrotal aching, which often gets better when you lie down.
• Symptoms that get worse after certain activities, such as bike riding or being on your feet for hours.
• Swollen testicle or scrotum.
• Size changes or differences in your testicles.
• Male infertility (inability to conceive after one year of trying).
• Small lump above the affected testicle. (8)

 Varicoceles and Infertility

Can varicoceles affect male fertility?

Yes. Varicoceles affect male fertility in some people. However, many people with varicoceles experience no reproductive obstacles.

Medical experts don’t understand exactly what role varicoceles play in male infertility. It’s possible that temperature changes inside your scrotum due to blood buildup in veins. This higher temperature may affect sperm count or production.

If you suspect infertility might be an issue for you, talk to a healthcare provider.

Fertility concerns are the top reason people get treated for varicoceles. Almost half of the partners who seek medical care for male infertility have a varicocele. (9, 10, 11 )

Diagnosis and Tests

How is a varicocele diagnosed?

A healthcare provider may diagnose a varicocele after examining your symptoms during a physical exam. To confirm a diagnosis, you might have an ultrasound test, which can provide more detail about your testicular veins.

Your provider may recommend semen tests or blood tests if you’re concerned that a varicocele may affect your fertility. Some insurance providers cover semen tests, but others might not. (12 , 13, 14 )

Management and Treatment

How can I treat a varicocele at home?

At-home treatment options for varicoceles include:

• No treatment: If a varicocele doesn’t bother you or cause fertility issues, you may not need treatment.

• Routine changes: You may choose to avoid certain activities that trigger discomfort. Wearing tighter-fitting underwear (like spandex) or a jockstrap can ease symptoms due to exercise or long periods of standing.

• Ice: Applying cold packs to your scrotum may help you feel better. To protect your skin, don’t apply ice directly to the skin. Wrap ice packs or cold gel packs in a towel and use about 15 minutes at a time.

• Over-the-counter medication: Acetaminophen or ibuprofen may take the edge off any minor scrotal or testicle aching that becomes distracting.

Varicocele Surgery

What is varicocele surgery?

Your provider may recommend surgery if the condition is painful or negatively impacts your life.

In varicocele surgery, a urologist (a doctor specializing in male reproductive organs) clips or ties off the veins that are causing symptoms.

The clips stop blood from flowing through those veins.

The surgery is an outpatient procedure, meaning you go home the same day. Most people can return to work about three days after surgery and resume exercise and sexual activity in a week or two.

You might still be able to feel a varicocele after surgery, but the veins will no longer be connected to the rest of your body and will no longer cause pain or harm to sperm production.

Many men and people AMAB choose to have surgery to improve fertility. Several studies have found that sperm numbers and motility (sperm’s ability to reach the egg) improve after varicocele surgery.

Partners who have the varicocele fixed maybe 40% to 50% more likely to get pregnant than those who don’t. (15, 16, 17 )

Prevention

Can I prevent varicoceles?

The medical community is unsure what causes a varicocele to develop. For this reason, you can’t prevent it. (18)

Outlook / Prognosis

What is the prognosis (outlook) for people with varicoceles?

Many people with a varicocele have no symptoms at all. While some people with a varicocele experience mild discomfort during certain activities, it doesn’t cause serious or long-term health problems.

If you’re concerned about your fertility, talk to your healthcare provider about whether surgery to treat a varicocele may improve your chances of having a child. (19)

Living with varicocele?

What questions should I ask my doctor?

If you have a varicocele, you may want to ask your healthcare provider:

Do I need treatment?

Are my symptoms likely to get worse without treatment?

What steps can I take to improve my symptoms at home?

Could the varicocele affect my fertility?

What are my treatment options?

Can surgery improve my fertility?

FAQ (Frequently Asked Questions)

How common are varicoceles?

Varicoceles affect 15% to 20% of all men and people assigned male at birth (AMAB) in the U.S. — about 1 in 5. In most people who have a varicocele, it occurs on the left side.

Less commonly, it can sometimes affect the right-sided scrotum or both sides.

Who gets varicoceles?

Varicoceles can happen to anyone with testicles, at any age. Healthcare providers believe many cases are congenital (present at birth).

Often, people notice a varicocele during their teenage years. Medical experts suspect this timing has to do with puberty when blood flow to the genitals increases.

Sometimes, the varicocele can prevent your testicle from growing properly.

What does a varicocele feel like?

Varicoceles may cause mild discomfort, aches, or pain, usually in your left testicle. Larger, swollen veins in your scrotal sac often feel or look like a bag of worms (or spaghetti). A small varicocele may be too small to see or feel.

Conclusion

A varicocele is a common condition that can affect men and people assigned male at the birth of different ages and stages of life. Most people experience mild or no symptoms. Deciding whether to treat a varicocele is up to you.

Wearing a supportive jockstrap or taking over-the-counter pain medication may be enough to resolve minor symptoms.

Varicoceles can cause male infertility. Surgery to repair a varicocele can sometimes improve fertility.

Talk with your healthcare provider about your treatment options, including how surgery may impact your reproductive future.

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