Question:
My husband has a severe varicocele on the left. The sperm count is 0.8 million in total and has 5% motility after 1 hour. What should be our first option: should we do varicocele repair first or should we go for IVF/ICSI?
Thank you for your help in advance. S. from Illinois.
Answer:
Hello S. from Illinois,
The severely decreased sperm count is probably not from the varicocele but other factors. Several studies have shown that removing the varicocele make little difference, and so nowadays it is not recommended. Many Urologists will recommend it and do the procedure because that is the only treatment they can offer. I think most infertility centers will recommend proceeding directly to IVF/ICSI. That is what I recommend. Besides, if your husband goes through this surgery and the semen analysis is still abnormal, you will still have to go to IVF with ICSI.
Why not go to your infertility clinic directly and get pregnant? :)
Good Luck,
Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program
Monterey, California, U.S.A.
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