Q. Should I go ahead with varicocelectomy to improve my sperm count?

Answered by
Dr. Radhakrishnan Nair B
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Jul 14, 2016 and last reviewed on: May 27, 2020

Hi doctor,

I have been diagnosed with bilateral varicocele grade II and III. My urologist recommended microscopic varicocelectomy after reviewing my test results. I am 32 years old and all of my blood test results, including hormones were in the normal range. However, my semen analysis showed that there are approximately 34 million sperms and out of which 60% are of good motility that is approximately 20 million. My semen analysis from 6 years ago was nearly 90 million sperm count with 60% motility. I understand that my current sperm count is at the bottom of the normal range. Me and my wife are not planning to have kids for the next one or two years and have not tried yet. My doctor recommends the surgery because there is going to be some improvement in the sperm count if he performs the procedure. I prefer to avoid the surgery if not necessary. I have a few questions. Is the sperm count going to be significantly different three years from now after performing the procedure? Is there a downside with leaving a permanent suture in my body for the rest of my life? What happens to the permanent sutures if the veins shrink or get absorbed by the body? I am not comfortable with leaving an external object (silk in my case) in my body for the rest of my life, especially if it causes problems in the future and I have to remove it later on. I am a highly active person and play soccer and go to the gym regularly. I am not sure how experienced the doctor should be for this procedure. My doctor is relatively young and obviously less experienced. Please help.

Dr. Radhakrishnan Nair B

Obstetrics And Gynaecology Sexology
#

Hi,

Welcome to icliniq.com.

  • Your semen concentration is very much within normal limits. You have not mentioned the morphology and motility in detail.
  • As far as I know microsurgical varicocelectomy should be done only when two parameters are affected. Either the count and motility are low or count and morphology are low or morphology and motility are in the lower range as per the WHO guidelines (World Health Organization).
  • Moreover, it is indicated only if your wife is not getting pregnant. I do not think that you should be going ahead with the surgery now.
  • In fact I strongly recommend you to plan for pregnancy at the earliest and in case no pregnancy after a year and if your wife is normal, then you can contemplate on surgery.
  • Semen analysis varies from laboratory to laboratory and time to time. So, I suggest you to get an evaluation for your wife also and decide accordingly.
  • If you can send me the semen analysis report in detail, then I can help you more.

Revert back with the report to a sexologist online --> https://www.icliniq.com/ask-a-doctor-online/sexologist


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