IPSILATERAL TESTICULAR HYPOTROPHY IS ASSOCIATED WITH DECREASED SPERM COUNTS IN INFERTILE MEN WITH VARICOCELES

Purpose: The presence of ipsilateral testicular growth retardation (hy potrophy) is the most common indication for prophylactic varicocele re pair in adolescents in an effort to prevent future infertility. We exa mined the relationship between semen parameters and ipsilateral versus contralateral testicular size in men with unilateral varicoceles to d etermine whether testicular size is an appropriate parameter for predi cting future fertility. Materials and Methods: We studied the records of consecutive patients with palpable unilateral left varicoceles for whom a history, physical examination and semen analysis were available . Total motile sperm counts of men with and without ipsilateral testic ular hypotrophy were compared. Results: We identified 611 patients wit h unilateral clinical left varicoceles, including 305 (50%) with ipsil ateral testicular hypotrophy. Mean total motile sperm counts plus or m inus standard error of mean were significantly less in the patients wi th than without testicular hypotrophy (80 +/- 5.2 versus 126 +/- 7.8 x 10(6) sperm, p = 0.0018). Hypotrophy was more common in patients with large varicoceles (73%) than in those with medium (53%) or small (43% ) varicoceles. Conclusions: Infertile patients with testicular hypotro phy associated with unilateral varicoceles have worse semen parameters than those without hypotrophy. These data support the practice of var icocele repair in adolescents with varicocele associated testicular gr owth retardation.