Effects of varicocele on male fertility

Varicoceles are vascular lesions of the pampiniform plexus and are the most common identifiable abnormality found in men being evaluated for infertili ty, Despite the long history associated with varicoceles, there remains muc h controversy regarding their diagnosis and management, The purpose of this manuscript is to address three of the most pressing controversies: (i) the association of varicoceles with male infertility, (ii) whether varicoceles exert a progressive deleterious effect and (iii) the relationship of varic ocele size and outcome following varicocele repair. The current literature is reviewed in an effort to answer these questions, Based upon this analysi s, conclusions can be drawn regarding the best management of varicoceles in subfertile men, adolescents, young fertile men and men with subclinical va ricoceles, Although there remain many controversies due to a paucity of dat a, there appears to be a significant difference between adults and adolesce nts with respect to a progressive deterioration of semen parameters and it is clear that subclinical varicoceles do not play a major role in male infe rtility.