Is it possible for a girl to get pregnant by a guy with varicocele? Does it definitely mean he is infertile? I've read that it might not even affect fertility.

--Karen

Varicoceles are a dilation of veins around the scrotum. They are most frequently seen on the left side, and they look and feel like a "bag of worms." The varicocele results in pooling of blood. As blood pools in the dilated veins, the temperature surrounding the testicle is increased. It is believed that this may cause abnormal sperm production.

Unfortunately, there are many unanswered questions about varicoceles. The role of varicocele and infertility is not well worked out. You are correct in stating that in many men, varicocele may not affect fertility. In fact, despite having a large varicocele, I have two wonderful kids. In fact, varicoceles seem to be present in equal numbers of fertile and infertile men.

Among men who undergo surgery to correct a large varicocele, up to 60 percent will see an improvement in semen analysis and 20-30 percent will be able to impregnate their partners. As for the rest, it seems likely that either the varicocele was not the cause of the infertility or that it was only one factor. Other factors may have been overlooked when the varicocele was discovered.

Treatment is best carried out by outpatient ligation (tying off) of the dilated veins. This is often expensive, however. If the semen is suitable, IUI (intrauterine insemination) may be more cost-effective. If severe abnormalities are present or if the woman also has factors affecting her fertility, then in vitro fertilization with ICSI (sperm injection) may offer a much better chance of success.