title: The clinical varicocele in infertility.
abstract: Of 238 infertile males seen over a 47-month period, 47 (20%) had a varicocele. Of these 51% had an abnormal sperm count (21% were azoospermic and 30% oligozoospermic) and 60% had less than a third of sperms motile; 23 patients were subjected to gonadotrophin assays. Serum follicle stimulating hormone and leutinising hormone levels were elevated in 48% and 70% of patients respectively. Serum prolactin assayed in 19 patients was raised in 10% and serum testosterone estimated in 16 patients was low in 6%. Twenty-five patients (53%) were advised to undergo surgery but only 10 agreed. Of these, 1 showed a dramatic improvement in his spermiogram and a pregnancy ensued. The sperm count and motility of 2 others improved after treatment with prostaglandin synthetase inhibitors, and 1 after testosterone. Medical treatment improved the count and motility in 7 of 8 patients in whom surgery was not suggested as primary treatment because of abnormal hormonal results. This study has shown that infertile patients with varicocele are a heterogeneous group and that improvement in spermiograms can best be achieved by selective treatment; this may be surgery, surgery followed by medical treatment, or medical treatment alone.
mesh_terms: D005640:Follicle Stimulating Hormone / Q000097:blood; D006801:Humans; D007248:Infertility, Male / Q000150:complications*; D007986:Luteinizing Hormone / Q000097:blood; D008297:Male; D011388:Prolactin / Q000097:blood; D012189:Retrospective Studies; D013076:Sperm Count; D013739:Testosterone / Q000097:blood; D014646:Varicocele / Q000097:blood / Q000150:complications* / Q000628:therapy
chemical_list: D013739:Testosterone; D011388:Prolactin; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone