Table 7.

Varicocele controversy

Varicoceles occur in 15% of men in general and in 30% of subfertile men. Varicoceles probably impair spermatogenesis by increasing the temperature in the scrotum. Achievement of pregnancies is often attributed to varicocele surgery because semen quality may improve after surgery and because conceptions occur in 15% of infertile men with or without surgery. However, clinical trials are equivocal. Varicoceles can be ligated or embolised, but as it may take one to two years for the couple to achieve a pregnancy, clinicians may recommend assisted conception if the woman is older than 35 years