THE VARICOCELE ENIGMA: "BACKGROUND NOISE" OR COMMON MALE INFERTILITY ETIOLOGY?

Infertility derived from mate etiology is a health problem which has increased over the last decades. Varicocele is a common cause for mate infertility with incidence of 35% and 75% among males with primary and secondary infertility, respectively, compared to 10%-15% among the general population. VaricoceLe is defined as dilated and entangled pampiniform plexus and internal spermatic veins located in the spermatic cord. The effect of varicocele on male infertility was controversial due to lack of published data uniformity and high standard studies. During recent years several published researches supplied reliable evidence regarding the influence of varicocele on mate infertility, treatment options and appropriate indications. Adequate patient selection significantly improves the chances for spontaneous pregnancy. Treatment varies between surgical veins ligation by various means and embolization by the endovascular approlch of the dilated veins. The current article summarizes updated treatment indications, advantages and drawbacks of the optional approaches and describes the considerations for choosing the optimal treatment for the infertile couple due to varicocele.