title: Varicocele repair: does it still have a role in infertility treatment?
abstract: OBJECTIVE
  To review the role of varicocele repair in the treatment of male infertility.
  
  
  RESULTS
  Since the advent of technologies bypassing boundaries of natural selection, this question may seem outdated. Over the past 20 years, fertility has decreased, and testicular damage (cryptorchidism, tumors) has increased. Thus the exploration of the infertile male is still unavoidable. However, what should be done and assigned to the discovery of a varicocele?The issue raised is whether varicocele found during the review of the infertile couple should be treated or 'ignored'.This study will update significant findings with regards to the pathophysiology of varicocele-induced infertility, such as oxidative stress and role of varicocele in bilaterality of testicular damage. Benefits of varicocele repair in semen analysis and simplifications of assisted reproductive techniques are reported. But reviews of randomized clinical trials have raised doubts about the benefit of varicocele treatment in infertile men.
  
  
  CONCLUSIONS
  We conclude that varicocele repair may be effective in men with subnormal semen analysis, a clinical varicocele and otherwise unexplained infertility. Deleterious cofactors, like obesity or smoking, could also be reduced for the benefit of general health and fertility.
authors.affiliation: Department of Andrology, Calmette Hospital, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Nevoux
authors.forename: Valérie
authors.initials: V
authors.lastname: Mitchell
authors.forename: Daniel
authors.initials: D
authors.lastname: Chevallier
authors.forename: Jean-Marc
authors.initials: JM
authors.lastname: Rigot
authors.forename: François
authors.initials: F
authors.lastname: Marcelli
mesh_terms: D006801:Humans; D007248:Infertility, Male / Q000601:surgery*; D008297:Male; D014646:Varicocele / Q000601:surgery*