Date of Award


Document Type

Scholarly Project

Degree Name

Master of Physician Assistant Studies (MPAS)


Physician Assistant Studies

First Advisor

Daryl Sieg


Varicocele, varicocelectomy, in Vitro fertilization, intracytoplasmic sperm injection, efficacy, cost effectiveness


Clinical varicoceles are the most frequent physical finding associated with infertile men and impaired semen parameters. There is evidence that suggests varicocele repair improves semen parameter and increases the chances of natural pregnancy. Today, varicocele repair is often combined with assisted reproductive techniques (ART) such as intrauterine insemination (IUI), in Vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI). In this literature review, data examining whether varicocelectomy before ART leads to improved pregnancy outcomes is reviewed. Current data suggest that there is a significant clinical benefit when correcting a varicocele in oligospermic men before IVF/ICSI. Similarly, men with non-obstructive azoospermia also benefit from varicocelectomy before IVF/ICSI, but not significantly. Furthermore, in couples seeking to use ART to conceive, varicocelectomy may offer improvement in semen parameters and therefore, decrease the level of ART needed to achieve pregnancy.