Up to 15% of men are thought to suffer from varicoceles--dilation of veins in the scrotum--which sometimes leads to lower fertility because of decreased sperm quality and quantity arising from testicular damage. Varicocele repair is a widely used treatment for men with fertility problems, although its efficacy has not been clearly illustrated in previous randomised trials.
Johannes Evers from University Hospital, Maastricht, The Netherlands, and John Collins from McMaster University, Hamilton, Canada, reanalysed data from seven previously published trials in this field to assess whether varicocele treatment resulted in increased pregnancy rates compared with controls.
Varicocele treatment had very little effect, with around a 1% increased pregnancy rate compared with men not given treatment (Overall, 61 pregnancies were reported among 281 (22%) subfertile couples assigned to varicocele repair, and 50 pregnancies were reported among 259 (19%) couples assigned no treatment, delayed treatment, or counselling).
Contact: Professor Johannes LH Evers, Department of Obstetrics & Gynaecology, University Hospital, P.O.Box 5800, 6202 AZ Maastricht, Netherlands;
T) 043-387-6543;
F) 043-387-4765;
E) jev@sgyn.azm.nl
Journal
The Lancet