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Varicocele Treatment Does Not Improve Male Fertility
Authors of a systematic review in this week’s issue of the Lancet highlight how a common treatment for impaired male fertility may well be ineffective.05/06/2003
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Up to 15% of men are thought to suffer from varicoceles and varicocele repair is a widely used treatment for men with fertility problems, although its efficacy has not been clearly illustrated in previous randomised trials.
Johannes Evers from University Hospital, Maastricht, The Netherlands, and John Collins from McMaster University, Hamilton, Canada, reanalysed data from seven previously published trials in this field to assess whether varicocele treatment resulted in increased pregnancy rates compared with controls.
Varicocele treatment had very little effect, with around a 1% increased pregnancy rate compared with men not given treatment (Overall, 61 pregnancies were reported among 281 (22%) subfertile couples assigned to varicocele repair, and 50 pregnancies were reported among 259 (19%) couples assigned no treatment, delayed treatment, or counselling).
An accompanying Commentary (p 1838) by Alan Templeton from the University of Aberdeen, UK, states that future research should compare varicocele treatment with in-vitro fertilisation, and that couples’ preferences and cost-effectiveness should be taken into account. He concludes: “As in many other areas of andrology, there is a need for continuing basic research, focused on the aetiology of varicocele with the intention of identifying the features that are associated with infertility and how they might be prevented.”
MEDICA.de, Source: The Lancet
Messe Düsseldorf