Is Surgery The Right Treatment For Varicocele?

Posted on Wed, 17 Dec 2014

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Wed, 17 Dec 2014 Answered on

Tue, 13 Jan 2015 Last reviewed on

Question : Hi,

Me and my wife have been married from past 3.5 years now and trying for a baby from past 6 months but have not been successful.

I have been recently detected with a bilateral grade 1 varicocele (2-3 mm) and have been told by Urologist to go for a Bilateral Microsurgical Varicocelectomy to improve my sperm count/motility.

He has also suggested Tab Origocare Forte and Neurokind Plus to increase sperm count/motility which I have been taking from past 1 month.

Below is my Semen Routine Examination report taken last month :

Physical Quantity : 1.5 ml

Chemical :
Fructose : Present
pH : Akaline

Microscopy :
Sperm Concentration : 80
Sperm Motility at 37 C : 40%
Grade :
Progressive 30%
Non Progressive : 10%
Immotile : 60%

Morphology :
Abnormal forms : 20%

Cellular Elements :
Epithelial cells : 1-2 per hpf
Leucocytes : 3-4 per hpf
Spermatogenic cells : Few
RBC : Absent

We have also been suggested to go for IUI for pregnancy.

I would like to know the following things :
1) Is the surgery required as it seems to be a mild varicocele ?
2) After seeing my above Semen report , what can you suggest on our chances of conceiving ?
3) Does taking the medicines suggested by the Urologist has any good effects in improving sperm count/motility and in how many months ?

Answered by Dr. Mahesh Koregol (40 minutes later)

Brief Answer:
No need of surgery

Detailed Answer:
Hi,

I read your query and I understand your concerns.

Following is my reply:

1. Surgery is NOT required for this mild varicocele.

2. Your motility is low by just 10 percent. Your chance of conceiving are good.

3. Taking medicines as suggested by urologist is a good step. Please take them.

4. Go ahead with IUI. Get HSG test done for your wife.

Let me know if you have any more doubts.

Regards,

Dr. Mahesh Koregol
IVF & Infertility Specialist

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Mahesh Koregol (23 hours later)

Thank you so much for the reply.

I have few concerns regarding IUI procedure and would require your expert advise. My wife was going through ovulation monitoring and she has ovulated today at around 12 pm. We are planning to go for IUI and have it before noon tomorrow.

1) Is above time suitable for having a successful IUI as per my understanding the egg only has a span of 24 hrs ?
2) For future IUI's , would like to know if there are any kits available in the market which can detect ovulation 24-36 hrs before. In this case, IUI can be planned properly and performed at the right time just before/after ovulation.
3) Can we have sex after IUI tomorrow in evening time or do we need to abstain from it ?
4) For future IUI's , would like to know how many days I can abstain from intercourse or ejaculating before going for IUI ?

Thanks in advance.

Answered by Dr. Mahesh Koregol (8 minutes later)

Brief Answer:
I have answered your follow-up queries.

Detailed Answer:
Hi

1. Though ovulation changes are observed at 12 today by ovulation kit, actual ovulation takes 36 hours after seeing positive on kit. So you can safely get IUI done tomorrow.

2. I sure detects ovulation 36 hours prior.

3.Yes you can have intercourse after IUI tomorrow.

4. 3 days of abstinence is enough.

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj