Outline:

  1. What is a varicocele? https://www.mayoclinic.org/diseases-conditions/varicocele/symptoms-causes/syc-20378771#

    1. Very common, experienced by 15% of people with testicles
    2. What causes a varicocele
    3. How a varicocele is diagnosed

  2. How varicocele affects fertility: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3046876/

    1. Most varicocele patients are not infertile, but they can affect semen parameters

    2. Mechanisms by which varicocele affects sperm health:

      1. Increased heat in scrotum
      2. Altered blood flow to testes
      3. Oxidative stress

      https://s3-us-west-2.amazonaws.com/secure.notion-static.com/229b961d-1f8b-4f07-a4e5-0a7e3febbd9f/Screen_Shot_2021-04-02_at_5.46.38_PM.png

    3. Impact of varicocele on fertility:

      1. Reduced semen parameters: https://pubmed.ncbi.nlm.nih.gov/33689198/
      2. Increased sperm DNA fragmentation: https://pubmed.ncbi.nlm.nih.gov/16500329/, https://pubmed.ncbi.nlm.nih.gov/33689198/, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6125150/

  3. Should I treat my varicocele/get surgery to fix? (if it is causing pain, or affecting your fertility in a significant way, and you want to conceive, then yes—get semen analysis and sperm DNA frag analysis to confirm)

  4. Evidence of improved semen parameters after surgery: https://pubmed.ncbi.nlm.nih.gov/27526630/ https://pubmed.ncbi.nlm.nih.gov/33763931/, https://pubmed.ncbi.nlm.nih.gov/29051002/

  5. Evidence of improved pregnancy rates after surgery: https://pubmed.ncbi.nlm.nih.gov/27526630/ https://pubmed.ncbi.nlm.nih.gov/33355829/