Published online Apr 16, 2014. doi: 10.12998/wjcc.v2.i4.94
Revised: February 10, 2014
Accepted: February 20, 2014
Published online: April 16, 2014
Varicocele has been implicated as a cause in 35%-50% of patients with primary infertility and up to 81% of men with secondary infertility. Although a large number of reports have shown improvement in the semen parameters after correction of varicocele, other studies have suggested no benefit. We report the first case of azoospermia after surgery in a young infertile male patient with left-sided varicocele and severe oligozoospermia undergoing laparoscopic varicocelectomy. A pregnancy was only achieved with assisted reproductive technology because semen cryopreservation was performed before surgery. In the light of the above, the deterioration of sperm count after varicocele repair in patients with severe oligozoospermia could be due to irreversible impairment of spermatogenesis of such patients, together with the possible temporary damage of the surgical repair. This possible complication could therefore turn the severe oligozoospermia into an indication to perform cryopreservation before surgery, on both clinical and medico-legal grounds. Further research is needed before drawing definitive conclusions regarding the management of varicocele-related severe oligozoospermia.
Core tip: We report a case of deterioration of sperm count after varicocele repair in a patient with severe oligozoospermia. This possible complication could therefore turn severe oligozoospermia into an indication to perform cryopreservation before surgery, on both clinical and medico-legal grounds.