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Surgical Procedures for Infertility in Men

Surgery may be performed to treat obstructions in the male reproductive tract or to correct varicoceles, which are when the veins that drain the testes become dilated.

Surgical procedures include:

Vasoepididymostomy

This is a microsurgical procedure used to correct obstructions in the epididymis—the coiled tube that connects the testes with the sperm-carrying tubes known as the vas deferens. These obstructions may be caused by congenital abnormalities, infections like chlamydia or tuberculosis , previous surgeries, or a vasectomy .

Varicocele Repair

Varicoceles are a common condition characterized by dilation of the veins that drain the testes. They often develop after puberty, although many are not detected until evaluation for fertility problems. Varicoceles are the most common cause for male infertility. Not all varicoceles require treatment, although most doctors recommend treating varicoceles if you are experiencing infertility. Even though they do not represent a health risk, they can contribute to deterioration of fertility over time.

This surgery is typically performed as an outpatient procedure and consists of a small incision just below the groin. The procedure may be performed under local or general anesthesia. The surgeon may use a microscope to find and preserve the tiny arteries that transport blood to the testes. Laparoscopy, which involves inserting a thin tube mounted with a video camera through a small abdominal incision, can also be used to repair varicoceles.

Revision Information

  • Donkol Rh, Salem T. Paternity after varicocelectomy: preoperative sonographic parameters of success. J Ultrasound Med. 2007;26:593-599.

  • Infertility in men. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T902812/Infertility-in-men. Updated February 26, 2016. Accessed October 4, 2016.

  • Goldstein M, Tanrikut C. Microsurgical managmenet of male infertility. Nat Clin Pract Urol. 2006;3:381-391.

  • Practice Committee of the American Society for Reproductive Medicine. The role of tubal reconstructive surgery in the era of assisted reproductive technologies. Fertil Steril. 2006;86:S31-4.