Infertility or sterility in men is a common concern among couples struggling to conceive. One of the most frequent and potentially treatable causes of male infertility is varicocele. This condition affects sperm quality and testicular function, raising an important question:
Can varicocele lead to infertility or sterility in men?
This article reviews the relationship between varicocele and male infertility, based on recommendations from the World Health Organization (WHO).
Varicocele is defined as abnormal dilation of the veins within the scrotum. It may contribute to infertility or sterility by:
While varicocele is strongly associated with male infertility, it does not usually cause permanent sterility if diagnosed and treated appropriately.
Are antioxidants effective in preventing infertility or sterility?
According to the WHO Guideline Development Group (GDG):
For men with infertility who have one or more semen parameters outside the WHO reference ranges and are attempting conception—either naturally or through assisted reproductive techniques—no recommendation for or against the use of antioxidant supplements can currently be made.
Scientific explanation:
Although proper nutrition is important for both partners during the preconception period, the effect of antioxidant supplementation on men with specific male-factor pathologies and couples experiencing infertility or sterility remains unclear.
Should varicocele be treated?
For men with infertility and clinically diagnosed varicocele, the WHO suggests:
📌 This is a conditional recommendation based on low-certainty evidence.
Who benefits most from varicocele treatment?
Men with:
are more likely to benefit from varicocele treatment compared to men with normal semen parameters. Treating varicocele in these cases may reduce the risk of infertility or sterility and improve natural conception rates.
⚠️ These recommendations apply to men in infertile couples not using assisted reproductive technologies (ART).
Surgical vs radiological treatment
For infertile men undergoing varicocele treatment, the WHO suggests:
Microsurgical varicocelectomy, or Radiological embolization
📌 This recommendation is conditional and based on very low-certainty evidence.
Factors influencing treatment choice:
✔️ Varicocele is a common cause of male infertility
✔️ It does not usually result in permanent sterility
✔️ Early diagnosis and appropriate treatment can significantly improve sperm quality
✔️ Following WHO-based recommendations helps reduce the risk of infertility or sterility
📍 Men diagnosed with varicocele should undergo individualized evaluation to determine the most effective treatment approach.
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