Varicoceles in the pediatric and adolescent population: threat to future fertility?

Deborah L. Jacobson, Emilie K. Johnson*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

5 Scopus citations

Abstract

Determining the effect of varicoceles on future fertility is challenging owing to multiple issues in children/adolescents, including: limitations in obtaining and interpreting semen analyses; potential for unequal differential testicular growth during puberty regardless of varicocele presence; and the potential for a lengthy interval between surgical intervention for varicocele in adolescence and attempts at paternity. This review presents a summary and evaluation of the available evidence relating to future fertility among children and adolescents with varicoceles. Data relating to proxy fertility measures in children/adolescents, including testicular size asymmetry and semen analysis abnormalities, demonstrate that these proxy measures are imperfect predictors of future fertility. Two large, recently published series of adolescents undergoing varicocele treatment showed conflicting paternity outcomes. Pediatric and adolescent varicocele will remain a clinical conundrum, subject to both over- and under-treatment, until more definitive prospective data are available.

Original languageEnglish (US)
Pages (from-to)370-377
Number of pages8
JournalFertility and Sterility
Volume108
Issue number3
DOIs
StatePublished - Sep 2017

Keywords

  • Fertility
  • pediatrics
  • varicocele

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynecology

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