Although varicoceles are a widely accepted identifiable male factor in infertile couples, the benefit of varicocele repair in improving pregnancy and live birth rates remains uncertain. The Study for Future Families obtained semen and reproductive hormone samples from US men whose partners were currently pregnant. In our analysis cohort of 709 men, a varicocele was detected by clinical examination in 56 (8%) of men. Men with varicocele had smaller left testis, and lower total and total motile sperm counts than men without varicocele. Gonadotropin levels were higher as well in men with varicocele. Interestingly, testosterone levels were also slightly higher in men with varicocele. Despite these differences, there was no difference between the groups in the time to achieve the study pregnancy or percentage of men with a previous pregnancy. We conclude that even in fertile men, varicoceles are associated with some degree of testicular hypofunction. This would support current recommendations to consider varicocele repair in male partners in infertile couples who demonstrate both a varicocele and abnormal semen parameters and after evaluation for treatable female factors.
Bibliographical noteFunding Information:
Funding information This work was supported by the following grants from the National Institutes of Health: R01-ES09916 to the University of Missouri; M01-RR00400 to the University of Minnesota; M01-RR0425 and UCLA CTSI Grant UL1TR000124 to the Los Angeles Biomedical Research Institute, Harbor-UCLA Medical Center and the Cedars-Sinai Research Institute. Support was also provided by the University of Iowa Center for Health Effects of Environmental Contamination cooperative project grant. In addition to the authors the Study for Future Families Research Group includes the following: B.S. Carter, D.J. Kelly, S.L. Stewart and T.M. Simmons (University of Missouri); J. W. Overstreet, C. Brazil, C Treece, C Tollner (University of California, Davis); R.S. Swerdloff, L. Lumbreras, S. Villanueva, M. Diaz-Romero, A. Victoroff, R. Sandoval, S. Bravarian, A. Leung and A.L. Nelson (Harbor-UCLA Medical Center); C. Hobel and B. Brock (Cedar-Sinai Medical Center); M. Hatch, M. Pfeiffer, L. Quinones, K. Polgar and A. Brembridge (Mt Sinai School of Medicine); C. Kwong, A. Muehlen, T. Perrier, T. Srb, J. Pryor and C. DeJonge (University of Minnesota). M. Swanson, T. Grider, L. Fisher, M. Maifeld, J. Whitham, A. Wolf, J. Sandlow (University of Iowa); F. Liu (Icahn School of Medicine at Mount Sinai). The authors also wish to acknowledge Dr. Niels J?rgensen and his laboratory at University of Copenhagen, Rigshospitalet for performance of the hormonal assays.
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- male hormones