Effectiveness of Bilateral Varicocelectomy on Male Infertility; a Case Series Study in Southern Iran

Abstract Background and Objective: Varicocele is a common cause of male infertility. The impact of varicocele treatment on fertility has been a topic of debate. Bilateral varicocele has been identified as a significant factor in infertility, offering hope for positive treatment results. This study aimed to assess the effectiveness of bilateral varicocelectomy on male infertility. Methods : A prospective study was conducted from January 2020 to January 2023, involving infertile men with varicocele. Varicocele diagnosis was performed using Color Doppler ultrasonography, and the contralateral maximum vein diameter was measured using an intraoperative Doppler device. Sperm parameters were assessed 6 months post-surgery, with fertility outcomes evaluated 12 months post-surgery. Results : A total of 180 patients participated in the study. Among them, 55 individuals (30.55%) had unilateral varicocele, while 125 cases (69.44%) presented with bilateral varicocele. Intraoperative measurements revealed a bilateral varicocele prevalence of 93.88% (169/180). Patient follow-up showed significant improvements in sperm parameters at 3 and 6 months post-varicocele surgery, with 59 patients (32.77%) achieving successful pregnancies 12 months after the procedure. Conclusions : The significance of bilateral varicocele in infertile men is often underestimated. Bilateral varicocelectomy has shown substantial benefits for male fertility. Thorough evaluation by experienced radiologists and andrologists is crucial to avoid missing important pathological findings or adverse treatment outcomes.