title: Reassessing the role of subclinical varicocele in infertile men with impaired semen quality: a prospective study.
abstract: OBJECTIVE
  To evaluate the seminal, hormonal, and spontaneous pregnancy outcome after percutaneous embolization of the internal spermatic vein in infertile men with left-sided subclinical varicocele and one or more abnormal semen parameters.
  
  
  METHODS
  A total of 218 patients underwent percutaneous embolization, and 119 patients were included as the observation group. All patients were followed up prospectively for 39.4 ± 6.5 months. Semen parameters and hormonal levels were evaluated before any procedure and 6 months after.
  
  
  RESULTS
  Significant improvement in the mean sperm concentration, total motility, and lower follicle-stimulating hormone levels was noted in those who underwent varicocele embolization as compared with those not treated. After 39.4 ± 6.5 months, pregnancy rates were 46.3% for the treated group and 11.8% for the control group (P = .011).
  
  
  CONCLUSIONS
  In infertile men, small varicoceles, even subclinical ones, should be identified and treated.
authors: Institute of Urology, A.O. Ospedali Riuniti di Ancona, Ancona, Italy. Electronic address: ubaldocantoro@tiscali.it.
authors: Ubaldo
authors: U
authors: Cantoro
authors: Institute of Urology, A.O. Ospedali Riuniti di Ancona, Ancona, Italy.
authors: Massimo
authors: M
authors: Polito
authors: Institute of Urology, A.O. Ospedali Riuniti di Ancona, Ancona, Italy.
authors: Giovanni
authors: G
authors: Muzzonigro
mesh_terms: D000293:Adolescent; D000328:Adult; D058070:Asymptomatic Diseases; D004621:Embolization, Therapeutic; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D006801:Humans; D007248:Infertility, Male / Q000097:blood* / Q000150:complications / Q000628:therapy; D007986:Luteinizing Hormone / Q000097:blood; D008297:Male; D011247:Pregnancy; D018873:Pregnancy Rate; D011446:Prospective Studies; D012008:Recurrence; D013076:Sperm Count; D013081:Sperm Motility; D013085:Spermatic Cord / Q000098:blood supply; D013739:Testosterone / Q000097:blood; D014463:Ultrasonography; D014646:Varicocele / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D055815:Young Adult
chemical_list: D013739:Testosterone; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone