Varicocele

By RRM Academy Reviewed by Dr. Naomi Whittaker, MD, Board-Certified OBGYN, MIGS, NFPMC, FCI Updated May 14, 2026

A varicocele is an abnormal dilation of the pampiniform plexus veins within the scrotum, present in approximately 15% of men in the general population and in 35% or more of men evaluated for infertility.¹ The enlarged veins impair the countercurrent heat-exchange mechanism that keeps the testis cooler than core body temperature. This thermal dysregulation suppresses spermatogenesis and amplifies oxidative stress, damaging sperm DNA and reducing both sperm concentration and motility.²

Varicocele is one of the most surgically correctable causes of male factor infertility. Repair results in measurable improvement in semen parameters in the majority of men, and sperm DNA fragmentation decreases significantly following correction of testicular venous outflow.¹³⁴⁵ Microsurgical subinguinal varicocelectomy carries the highest success rates and the lowest rates of hydrocele formation and recurrence among available techniques.

Varicocele is also associated with OAT syndrome and is a contributing factor in a meaningful proportion of couples presenting with infertility. Restorative andrology evaluates the male partner for varicocele as part of the couple-based workup rather than bypassing the diagnosis with sperm extraction. and oxidative stress.

This content is for educational purposes only and does not constitute medical advice. Consult an RRM clinician or healthcare provider for guidance specific to your situation.