Varicocele and Male Fertility: Questions for a Reproductive Specialist
Understanding dilated scrotal veins, their impact on testicular temperature and sperm parameters, and when surgical repair helps.
Reviewed by Dr. Dileep Kumar H R, MBBS, DGO, DRM
October 2026 · Evidence-Based Healthcare
A varicocele is an abnormal enlargement of the pampiniform venous plexus in the scrotum, analogous to varicose veins in the legs.
It is present in approximately 15% of the general male population and up to 35-40% of men presenting with primary infertility.
Varicoceles impair fertility primarily by disrupting scrotal thermoregulation — elevating local temperatures by 1 to 2 degrees Celsius, which induces oxidative stress and sperm DNA fragmentation.
Not every varicocele requires treatment. Clinical repair (subinguinal microsurgical varicocelectomy) is indicated when the varicocele is clinically palpable, semen parameters are abnormal, and the female partner has normal fertility.
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Frequently Asked Questions
Yes. Some men experience a dull ache or heaviness in the scrotum, especially after prolonged standing or strenuous physical activity.