Varicocele Treatment in Azoospermia Before Artificial Reproductive Techniques: Critical Considerations by the EAU Guidelines Panel on Sexual and Reproductive Health.

Boeri, Luca; Dinkelman-Smit, Marij; Jensen, Christian Fuglesang S; Minhas, Suks; Salonia, Andrea; European Association of Urology Guidelines Panel on Sexual and Reproductive Health · Eur Urol · 2025

review · Level V

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Abstract

There is some evidence suggesting potential benefits of varicocelectomy in men with nonobstructive azoospermia (NOA), but it is not of sufficient quality to support a strong recommendation for this procedure. There is a possible benefit of surgical correction of clinically detectable varicocele in NOA patients without known genetic abnormalities and with a partner with no evidence of diminished ovarian reserve. Patient counseling should highlight the variability of the outcome data and the limited strength of the evidence available.