Varicocele and male factor infertility treatment: a new meta-analysis and review of the role of varicocele repair.
Baazeem A, Belzile E, Ciampi A et al.
Editor’s note: Clinically identifiable varicoceles are found in approximately 15% of men and are twice as common in males who present for infertility evaluation than those who do not. It has been suggested that varicocele repair reduces semen oxidative stress, sperm DNA damage, and ultramorphology; however, the pathophysiological reasons for these associations have not been proven. A review by Evers et al. found that there was insufficient evidence to support routine varicocele repair in subfertile men, as surgery did not significantly improve spontaneous pregnancy rates (Cochrane Database Syst Rev 2001;[1]:CD000479).