Low-grade left varicocele in patients over 30 years old:the effect of spermatic vein ligation on fertility.

Abstract

To evaluate the effect of spermatic vein ligation in patients over 30 years old and with low-grade left varicocele, and thus help to establish whether such patients might benefit from surgery. A randomized study was conducted on 68 infertile patients (30-38 years old) with evidence of sperm abnormalities and who had low-grade varicocele (grade I according to Hirsch), comparing left spermatic vein ligation with no treatment. The outcome was assessed by standard sperm analysis and eventual paternity. There was no improvement in sperm quality in either of the groups one year after surgery, and no significant difference in paternity. Left spermatic vein ligation for low-grade varicocele in patients more than 30 years old cannot be recommended.