Varicocele and infertility. Preoperative prognostic elements

In order to develop a procedure permitting a more accurate preoperative prognosis of varicocelectomy, we studied 59 subjects (20 to 40 years of age) who had undergone ligation of the spermatic vein for varicocele and infertility at least two years previously. The following preoperative parameters were evaluated: age, seminal fluid, plasma levels of LH and FSH and their maximal increase after LHRH stimulation, plasma levels of testosteone and its maximal increase after hCG (5000 U) administration, and testicular histology. Patients who failed to impregnate their wives after surgery were older, had higher plasma levels of FSH and a higher maximal increase in FSH and LH after LHRH stimulation, as well as more compromised testicular histology. Plasma levels of testosterone and seminal characteristics did not appear to constitute valid prognostic factors.