Low-grade left varicocele in patients over 30 years old: the effect of spermatic vein ligation on fertility

Objectives To evaluate the effect of spermatic vein ligation in patients ov er 30 years old and with low-grade left varicocele, and thus help to establ ish whether such patients might benefit from surgery. Patients and methods A randomized study was conducted on 68 infertile patie nts (30-38 years old) with evidence of sperm abnormalities and who had low- grade varicocele (grade I according to Hirsch), comparing left spermatic ve in ligation with no treatment, The outcome was assessed by standard sperm a nalysis and eventual paternity. Results There was no improvement in sperm quality in either of the groups o ne year after surgery, and no significant difference in paternity, Conclusions Left spermatic vein ligation for low-grade varicocele in patien ts more than 30 years old cannot be recommended.