Varicocele, the Most Common Cause of Treatable Infertility

Although testicular biopsy for histological studies is not recommended in patients with varicocele, it is known from past information that impaired spermatogenesis begins early in puberty and worsens with age. Treatment, whether surgical repair or percutaneous embolization, will, in most cases, improve testicular function, preserve fertility, and provide an effective method of treating testicular pain. There are a few patients in whom morphological and hormonal changes (testosterone, inhibin B, FSH, and LH) do not completely normalize. Histological studies have shown that there are patients with varicocele who have a previous pathology such as lobules with only Sertoli cells. On the other hand, the varicocele may already have produced a severe focal obstructive spermatogenic disorder due to compression of the testicular mediastinum of the rete testis cavities caused by dilated contractile veins, from which it is difficult to recover.