Male infertility is responsible for almost half of all cases of couples experiencing trouble conceiving. While it is true that men have far less causes of infertility compared to women, varicocele (pronounced VAR-ih-koe-seel) is a leading cause of male infertility. This condition is quite common. According to UCLA Health, 15% of American men develop a varicocele by the time they reach adulthood and about 40% of infertile men have a varicocele.
What Is A Varicocele?
Varicocele is an enlarged vein or cluster of veins within the scrotum, very similar to a varicose vein of the leg. The varicocele drains blood away from one or both of the testicles.
What Causes A Varicocele?
In a typical varicose vein of the leg, the valves in the vein lose strength and fail. With varicocele, the valves never formed, so as a boy goes through puberty and the reproductive organs grow, a varicocele may form.
No one is quite sure what causes a varicocele to happen. Varicoceles most often form during puberty and more often on the left side. This is probably due to the position of the left testicular vein. Naturopathic doctors feel that poor nutrition, environmental toxin exposure and possibly genetics may play a role in the integrity of the vein wall as a man ages.
Over time, varicoceles may become larger (dilate), increasing the chance of infertility. Regardless of the side that the varicocele is on, sperm production in either testicle or both may be affected. Why the left side more than the right side can be explained by either the angle of the left testicular vein as it enters the left renal vein, lack of anti-reflux valves, and increase renal vein pressure. There is a high chance that the right side is affected if the left side has one.
If you have been struggling to conceive and are experiencing any of the following symptoms, be sure to get in to see a doctor to get a sperm count and health test performed. The doctor can also help you to determine if a varicocele may be the culprit of your fertility struggles.
- Discomfort of the scrotum and testicles – dull, heavy or sharp
- A feeling of relief when lying on your back
- Discomfort worsens over the course of the day
- A noticeable enlargement in an area of the scrotum
Important note: There are several other conditions that may cause a noticeable mass of the scrotum, be sure to see a doctor if you notice a mass, or feel any sort of pain or swelling.
How a Varicocele May Cause Low Sperm Count and Poor Sperm Health
Infertility and Atrophy of the Affected Testicle
The testes are made up of sperm-producing tubules, which are responsible for the “bulk” and shape of each testicle. The affected testicle may shrink and become soft over time, due to the malfunctioning valves allowing blood to pool in the veins. The pooling blood results in increased pressure in the veins, which leaves the tissues of the testes and sperm to be exposed to damaging toxins in the blood. This toxin exposure may also play a role in the quality and quantity of sperm.
Another way a varicocele may impact male reproduction is through testicular temperature alteration. The testicular veins are responsible for cooling the blood in the testicular artery. The natural ability of the testicular veins to do this ensures that proper temperature is maintained for sperm production. If blood flow is blocked due to varicocele, testicular temperature may become too high, affecting sperm health, including count, formation (morphology) and movement (motility).
“A cross-sectional multicentre study of 7,035 young men [European men] were investigated from 1996 to 2010.” The men participated in physical examines, provided semen samples, and had reproductive hormone tests. Researchers shared in the journal European Urology that their study “demonstrated an adverse effect of increasing grade of varicocele on testicular function in men not selected due to fertility status.”
Not all men with varicocele will require treatment. Surgical and medical treatment options are suggested if there is pain present, testicular atrophy (shrinkage), infertility or if you are considering assisted reproductive treatment options such as IUI or IVF.
Surgically sealing off the affected veins will redirect blood flow to the healthy normal veins. This may improve sperm count and health, and in some cases cure the infertility.
There are limited risks associated with surgical varicocele repair according to the Urology Care Foundation, of the American Urological Association. Rare problems after surgery include build-up of fluid around testicles, recurrence of varicocele, or damage to a testicular artery. Talk to your doctor about surgical treatment options.
Natural Treatment Options
Natural therapies may be complementary to medical options and should not be relied on as the sole solution to the issue. Parents of sons may also want to consider the specific nutrients listed here, as a means of supporting the health of the testicular veins, as their son develops. This is especially important if varicocele runs in your family.
The idea here is to support the health of the tissues and vein walls, improve circulation to the testes, and improve cellular health to protect the sperm and reproductive tissues from free radical and toxin damage through specific nutrient and herbal support.
- Eat a whole food fertility diet – Whole foods are catalysts for antioxidants, which protect cells from free radical damage. Remember, sperm are cells.
- Avoid exposure to environmental toxins – This will help to prevent the sperm from being exposed to fewer toxins which may be present in the blood.
- Wear more supportive underwear, such as boxer briefs, which allow for adequate temperature of the testes, while still providing adequate support. Especially important if discomfort is present. Avoid boxers.
- Mixed antioxidant blend and CoQ10 Ubiquinol – Antioxidants protect sperm and delicate DNA within the sperm from free radical damage. I like Network Antioxidants and Fertilica Ubiquinol.
- Antioxidant intake in the diet – Food rich in antioxidants are berries, Goji berries, peppers, dark leafy greens, herbs like Ginkgo biloba.
- Cod Liver Oil – High in omega 3 essential fatty acids. DHA, one of the fatty acids contained in cod liver oil, has a significant impact on the viability and health of sperm. When there are not enough fatty acids present, cholesterol replaces the needed fatty acid in the sperm membrane. This prevents sperm from proper maturation.
- L-Carnitine – This amino acid shuttles omegas. L-Carnitine has been shown to help normalize sperm motility in men with low sperm quality. L-Carnitine helps sperm to metabolize fats and sugars for energy.
- L-Arginine – This amino acid increases natural circulation to the reproductive organs for improved detoxification and to bring oxygenated, nutrient rich blood to the sperm. L-Arginine has also been shown to increase sperm production and positively benefit sperm motility according to Mohamed Z. Gad, faculty of the Department of Biochemistry, Faculty of Pharmacy and Biotechnology, The German University in Cairo, Egypt. (Best done post-surgery)
- Selenium – This mineral is necessary for proper sperm formation. It is easy to get adequate selenium intake by eating 4-5 Brazil nuts a day.
- Supportive herbs:
When it comes to varicocele and male infertility, combined medical and natural treatments can be very successful in helping a man restore fertility and go on to have children.
- Yarnell, E. (March 9, 2014). Personal Communication. Lecture title: Male Infertility Talk.
- Varicocele: Symptoms, Treatment and Diagnosis. UCLA Health. Retrieved from http://urology.ucla.edu/body.cfm?id=478&ref=19&action=detail
- How are Varicoceles Treated? (n.d.) Retrieved from https://www.urologyhealth.org/urologic-conditions/varicoceles/treatment
- Barton-Schuster, D. (n.d.). Cod Liver Oil Essential for Healthy Fertility and Pregnancy. Retrieved from: https://natural-fertility-info.com/cod-liver-oil-essential-for-healthy-fertility-and-pregnancy.html
- Rodriguez, H., C.H., CMT. (n.d.). Increasing Low Sperm Count and Improving Male Fertility…. Retrieved from: https://natural-fertility-info.com/mens-fertility
- Barton-Schuster, D., CH, Doula. (n.d.). Top 5 Herbs For The Male Reproductive System. Retrieved from: https://natural-fertility-info.com/top-5-herbs-for-the-male-reproductive-system.html
- Barton-Schuster, D., CH, Doula. (n.d.). How Ubiquinol Can Improve Your Chances of Conception. Retrieved from: https://natural-fertility-info.com/antioxidant-ubiquinol.html
- Varicocele. (n.d.). Retrieved from: https://www.mayoclinic.org/diseases-conditions/varicocele/symptoms-causes/syc-20378771
- Varicoceles. (n.d.). Retrieved from: https://my.clevelandclinic.org/health/diseases/15239-varicocele
- Damsgaard J., Joensen U.N., Carlsen E., Erenpreiss J., Blomberg Jensen M., et al. (December 2016). Varicocele Is Associated with Impaired Semen Quality and Reproductive Hormone Levels: A Study of 7035 Healthy Young Men from Six European Countries. European Urology, 70 (6), pp. 1019-1029. Retrieved from https://www.europeanurology.com/article/S0302-2838(16)30396-7/fulltext
- Gad, M. (9 June 2010). Anti-aging effects of l-arginine. Journal of Advanced Research.
Volume 1, Issue 3, Pages 169-177. Retrieved from https://www.sciencedirect.com/science/article/pii/S2090123210000573#bib29