Evaluation of the Association of the Presence of Subclinical Varicocele with Subfertility in Men

Document Type : Original Article


Department of Andrology and Sexology, Faculty of Medicine, Cairo University, Cairo, Egypt


Background: The negative impact of clinical varicocele on fertility has been thoroughly investigated. On the other hand, subclinical varicocele is a well-defined ultrasonographic finding and is more common than clinical varicoceles. It remains to be resolved wheather or not subclinical varicocele is a contributor to subfertility in men.
Purpose: To investigate a possible association between subfertility and subclinical varicocele in men.
Patients and Methods: After exclusion of cases with clinical varicocele; a total of 40 subfertile men were compared to 40 fertile men regarding standard semen parameters and scrotal ultra-sonography findings.
A scrotal ultrasonography was performed to measure testicular veins diameters at, erect position. Also, to detect the presence/absence of reversal of blood flow (regurge) > 1 second in testicular veins during Valsalva maneuver. Subclinical varicocele was diagnosed when testicular vein diameter was ≥ 2.5 mm with positive regurge. Cases with subclinical varicocele had the testicular veins’ diameters correlated to the standard semen analysis parameters.
Results:There was significantly higher left and bilateral testicular vein(s) regurge and left sided subclinical varicocele in the subfertile group. Testicular veins diameters were not correlated to the standard semen parameters.
Conclusion: Subclinical varicocele should be considered as a possible etiological factor for subfertility in men.


Main Subjects