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What you should know about varicocele and asthenozoospermia

As we are going through #movember, the annual event involving the growing of mustaches during November in order to raise awareness of men’s health issues, such as prostate cancer, testicular cancer, etc., it is a great opportunity to remind everyone that infertility sees no gender. Actually, according to ASRM, male factor infertility issues account for 40% of all infertility problems. Two of the most common male factors are varicocele and asthenozoospermia, and now is the time you should learn more about them.

Varicocele

A varicocele is an enlargement of the veins within the loose bag of skin that holds the testicles. These veins transport oxygen-depleted blood from the testicles. A varicocele occurs when blood pools in the veins rather than circulating efficiently out of the testicles. It is usually created during puberty and if not treated may cause poor development of a testicle, low sperm production or other problems that may lead to infertility.

Symptoms of varicocele

  • Pain/discomfort.
  • Possible mass on the testicle.
  • Different testicle sizes, the affected testicle may be too small than the other one.
  • Infertility. An estimated 10% to 20% of men diagnosed with a varicocele experience difficulty fathering a child. Among those struggling with infertility, about 40% have a varicocele.

Varicocele and infertility have been a subject of debate for many years, as there are men with varicocele that can father children, even without intervention. In addition, improvements in semen quality after varicocelectomy do not always result in spontaneous pregnancy. 

Causes of varicocele

Scientists have still not concluded what can cause the condition, but there are certain lifestyle factors that may affect it. In some studies, it is suggested that smoking may have a greater adverse influence on the varicocele. Cigarette smoking increases an accumulation of cadmium in testes, and may cause testicular damage in men with varicocele. The same studies haven’t found significant correlation between alcohol and occupation with varicocele. 

How to diagnose varicocele

Most men who have it don’t notice something unusual, and many of them find out about the problem if they have already struggled with infertility. A doctor can often diagnose a varicocele during a physical exam by looking at the scrotum and feeling for lumps and unusual blood vessels. If the man has fertility issues, the doctor may also order a semen analysis to check his sperm quality.

Treatment

If it does not affect fertility or other health factors, varicocele doesn’t need treatment. It may need treatment when:

  • The man has a varicocele and a low sperm count or other problems with sperm.
  • The varicocele is causing pain or swelling.
  • The couple has unexplained infertility.

Treatment consists of two options, embolization and surgery. 

  • Embolization is surgery that temporarily cuts off the blood supply. A doctor can carry out this procedure in their office with local anesthesia, meaning a person will not feel any pain in the area. A 2012 study suggests that embolization may be unsuccessful in as many as 19.3% of cases. If embolization doesn’t work, surgeons may need to try a different procedure to treat the varicocele.
  • Varicocelectomy, the surgical removal of the varicocele by blocking the blood flow to the damaged vein. This type of surgery is usually more successful that embolization with failure rate less than 5%. General anesthesia is used during the procedure, and the person may experience some pain and tenderness for several days afterward. 

several sperms in a blue background

Asthenozoospermia

It happens when a man produces sperm with low motility, an essential requirement for natural conception. Reduced sperm motility decreases the chances of fertilization. The condition is defined as <40% sperm motility or less than 32% with progressive motility. 

Again with this condition the man can have a regular sexual activity without knowing he suffers from asthenozoospermia, and only when he tries to reproduce with no successful outcome to recognize it. 

According to the semen analysis, which indicates the motility and speed of the sperm, asthenozoospermia is classified into two categories according to its severity. Mild to moderate and severe. In the mild to moderate, the percentage of non-motile or poorly motile sperm is between 60% and 75% and in the severe it is sometimes higher than 80%. 

Causes of asthenozoospermia

Again here, scientists have not clearly concluded what causes the condition and usually it is a combination of environmental and genetic factors. In general sperm motility can be affected by excessive assumption of alcohol, smoking, advanced age, prolonged exposure to hot environments, testicular problems, cancer treatments, vasectomy and varicocele. A genetic cause that can cause asthenozoospermia is the Kartagener syndrome, a rare autosomal recessive disease characterized by defects in the structure and function of the cilia. This syndrome is associated with male infertility, as it affects sperm motility.

Treatment

As it is concluded by the causes that affect sperm motility, leading a healthy lifestyle surely helps to prevent the condition. In addition, it may be advisable to take a vitamin supplement containing antioxidants. Your doctor may recommend the intake of foods rich in vitamins or zinc, for example. The above applies if the condition is mild to moderate. If it is severe then it is recommended to perform a fertility treatment in order to maximize the chances of conceiving. The most recommended treatments in this case are IVF and ICSI

If, however, the cause of the asthenozoospermia is known, there are other alternatives. For example, if the cause is an infection, the specialist can prescribe the appropriate antibiotic treatment for the patient and the semen analysis should be repeated after 3 months, to check if everything is back to normal.

In any case, if you and your partner try to conceive for over a year (if you are under the age of 35) or for over 6 months ( if you are over 35) then you should consult with a fertility specialist and be informed about the available fertility treatments that can help you. 

We are here for your inquiries. You can dm/email us or book a free call with our customer success manager in order to further guide you along the process.

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What you should know about varicocele and asthenozoospermia
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