How Does Varicocele Cause Infertility?
Many theories have been proposed. To date, the most widely accepted mechanisms include sperm death due to: hyperthermia (high temperature) in the scrotum because of stagnant venous blood; reflux (backflow) of venous blood from the left adrenal gland, which exposes the testes to high levels of toxic metabolites (steroids, catecholamines); or changes in the reproductive hormonal balance. To properly identify a varicocele, the physician should examine the patient while he is standing. The cord structures will be palpated (felt) and compared. Then, the patient may be asked to perform a Valsalva maneuver (a forced “exhale” with a closed nose and mouth), which will increase venous reflux and make an existing varicocele more prominent. Additional palpation of the scrotum will be conducted while the patient is supine (lying down). The physician may confirm a diagnosis of varicocele using Doppler ultrasound testing (visual imaging of internal organs by means of ultrasound echos that identify ti
