Varicoceles

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Varicoceles

Does varicocele treatment improve fertility in men?

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Varicoceles can reduce men's . If men with a palpable varicocele (one that can be felt from the outside) and poor sperm quality have treatment, the chances of their partner becoming pregnant could improve. Men who have normal sperm quality and a small varicocele do not need to have this treatment.

Varicoceles are varicose veins in the scrotum (the sac that holds men's testicles). They develop if blood builds up in the testicles, permanently enlarging the veins. Varicoceles can reduce men's . Scientists don't yet fully understand why they can have this effect. Some believe that the quality of the sperm is poorer because the varicocele reduces the blood supply to the affected testicle. Others believe that the build-up of blood in the scrotum raises the temperature of the testicle, which could affect sperm production.

As well as considering treatment for a varicocele, it can be a good idea to seek advice from a clinic if you would like to have children and are having problems.

What are the treatment options for varicoceles?

The aim of varicocele treatment is to stop the blood from building up. This can be done by either closing off the vein using minimally invasive procedures (embolization) or by carrying out surgery to cut or tie off the vein. These procedures stop blood flowing through the affected vein. It then flows through nearby healthy veins instead.

The procedure is done in an outpatient setting (you don't have to stay overnight afterwards) and takes about 30 to 60 minutes. It usually takes about a day to recover, but you should avoid strenuous physical activity for 1 to 2 weeks afterwards.

How does the procedure affect your fertility?

Research has shown that women are somewhat more likely to become pregnant if their partner's varicocele is treated. But only if the men have a palpable varicocele (one that can be felt from the outside) and poor sperm quality before the procedure. The studies provide a rough estimate of how many men could benefit from this treatment.

  • About 21 out of 100 women became pregnant even though their partner's varicocele wasn't treated.
  • About 33 out of 100 women became pregnant after their partner's varicocele was treated.

The treatment wasn't found to help in the following men: Those who had a varicocele that could only be detected in an ultrasound scan (not felt from the outside) and who had normal sperm quality.

The researchers didn't gather information about improvements in sperm quality. Sperm quality can vary over time in all men so it doesn't allow any reliable conclusions to be drawn about their .

What risks are associated with the surgical procedure?

The surgical procedure can have side effects like bruising, an and nerve damage, but these usually go away again without any trouble. In very rare cases, the duct that carries the sperm cells from the testicles to the penis (the “vas deferens”) is damaged. A build-up of fluid in the testicles (hydrocele) is another possible side effect. Certain kinds of embolization () sometimes harm nearby blood vessels. Varicoceles might also come back again after treatment. Serious complications (like the loss of a testicle) are very rare.

Persad E, O'Loughlin CA, Kaur S et al. Surgical or radiological treatment for varicoceles in subfertile men. Cochrane Database Syst Rev 2021; (4): CD000479.

Pschyrembel online. 2025.

IQWiG health information is written with the aim of helping people understand the advantages and disadvantages of the main treatment options and health care services.

Because IQWiG is a German institute, some of the information provided here is specific to the German health care system. The suitability of any of the described options in an individual case can be determined by talking to a doctor. informedhealth.org can provide support for talks with doctors and other medical professionals, but cannot replace them. We do not offer individual consultations.

Our information is based on the results of good-quality studies. It is written by a team of health care professionals, scientists and editors, and reviewed by external experts. You can find a detailed description of how our health information is produced and updated in our methods.

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Does varicocele treatment improve fertility in men?

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Created on September 30, 2025

Next planned update: 2028

Publisher:

Institute for Quality and Efficiency in Health Care (IQWiG, Germany)

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