The procedure that can be contemplated is a varicocele treatment so, if a man has a clinical varicocele is a significant varicocele and has impaired sperm quality and difficulty conceiving, it’s not unreasonable to at least think about treating the varicocele. This isn’t I think consistent with the NICE advice but I have to say it is on the guidance for other international bodies. Varicocele treatment can be by surgery, it can be by the radiologists which block the tiny veins, drain the testicle and get rid of these varicose veins; they’re more likely to be on the left side than the right. The varicocele’s heat the testicles and impair sperm quality that way so treating the varicocele might or might not improve sperm quality but certainly the impact on pregnancy rates is a little bit harder to determine. Most studies that looked at it properly, have probably shown that perhaps a slight improvement but all these studies can be open to kind of criticism by experts as to how they were designed and run etc. So, the answer probably isn’t quite out there yet but certainly on a case-by-case basis, it’s not an unreasonable thing to at least think about.
