Operation Description
One of the most common causes of male infertility: Varicocele
A varicocele is a condition in which the veins in the testicles become enlarged and varicose. This can cause increased temperature and oxidative stress in the testicles, negatively impacting sperm production and quality. It is one of the most common and treatable causes of male infertility.
Microsurgical Approach to Varicocele Treatment
Today, the most effective and permanent solution to varicocele is microscopic varicocelectomy. In this procedure, the testicular veins are accessed through a 3-4 cm incision in the groin area and the enlarged veins are ligated using a surgical microscope. This regulates blood flow in the testicles and can significantly improve sperm quality.
🔹 Advantages of Microscopic Surgery:
• The veins are clearly visualized, allowing for more precise operation.
• The recurrence rate is as low as 0.1%.
• The improvement rate in sperm parameters is 60-75%. • The average chance of natural pregnancy is 30-50%.
In surgical procedures performed without a microscope, success rates are lower, and the recurrence rate can reach up to 40%.
Operative Process and Recovery
• Microsurgical varicocelectomy is performed under general or spinal anesthesia.
• Unilateral surgery takes an average of 45 minutes to 1 hour, while bilateral procedures can take 1.5 to 2 hours.
• Sexual intercourse is not recommended for the first 2 weeks and strenuous exercise is not recommended for the first 4 weeks after surgery.
• Patients are usually discharged the same day.
• Because the sperm production cycle lasts approximately 3 months, the first positive effects begin to be seen in the 3rd month.
Who is Suitable for Varicocelectomy?
All clinical characteristics of the couple are considered when deciding on treatment. Microscopic varicocele surgery may be recommended in the following cases:
🔹 For couples who have not yet tried IVF, and if the male sperm count, motility, or morphology are low;
If the woman is of suitable age and has adequate ovarian reserve, surgery can be performed to increase the chance of natural pregnancy.
For men with high sperm DNA damage that persists despite treatment;
For couples with recurrent pregnancy losses and abnormalities in sperm FISH testing;
For male factor considerations, such as recurrent IVF failure, poor embryo development, or failure to form blastocysts.
In such cases, microsurgical varicocele removal before IVF treatment can increase success rates.
When Should Assisted Reproductive Technologies Be Considered?
If there is no significant improvement in sperm parameters after microscopic varicocele surgery, or if natural pregnancy is not achieved within one year, a transition to assisted reproductive technologies (insemination or in vitro fertilization) should be considered.
At Momart IVF Center, we refer men diagnosed with varicoceles to appropriate treatment after a detailed evaluation. With our experienced team and advanced microsurgical techniques, we aim for high success rates.