title: Reassessing the value of varicocelectomy as a treatment for male subfertility with a new meta-analysis.
abstract: OBJECTIVE
  To determine the efficacy of varicocelectomy as a treatment for male factor infertility by improving the chance of spontaneous pregnancy.
  
  
  METHODS
  Meta-analysis.
  
  
  METHODS
  Cleveland Clinic's Glickman Urological Institute.
  
  
  METHODS
  Infertile men with abnormal results on semen analyses and a palpable varicocele.
  
  
  METHODS
  Surgical varicocelectomy.
  
  
  METHODS
  Spontaneous pregnancy outcome.
  
  
  RESULTS
  The odds of spontaneous pregnancy after surgical varicocelectomy, compared with no or medical treatment for palpable varicocele, were 2.87 (95% confidence interval [CI], 1.33-6.20) with use of a random-effects model or 2.63 (95% CI, 1.60-4.33) with use of a fixed-effects model. The number needed to treat was 5.7 (95% CI, 4.4-9.5).
  
  
  CONCLUSIONS
  Surgical varicocelectomy in infertile men with palpable lesions and at least one abnormal semen parameter improves the odds of spontaneous pregnancy in their female partners. Five studies were included (two randomized, three observational). All were scored for bias. Our study suggests that varicocelectomy in selected patients does indeed have beneficial effects on fertility status.
authors: Division of Urology, Robert Wood Johnson Medical School at Camden, Camden, New Jersey, USA.
authors: Joel L
authors: JL
authors: Marmar
authors: Ashok
authors: A
authors: Agarwal
authors: Sushil
authors: S
authors: Prabakaran
authors: Rishi
authors: R
authors: Agarwal
authors: Robert A
authors: RA
authors: Short
authors: Susan
authors: S
authors: Benoff
authors: Anthony J
authors: AJ
authors: Thomas
mesh_terms: D005260:Female; D006801:Humans; D007248:Infertility, Male / Q000628:therapy*; D008297:Male; D011247:Pregnancy; D011256:Pregnancy Outcome; D014646:Varicocele / Q000601:surgery*