Varicocele is the most common pathology identified in couples presenting to clinics with complaints of male infertility. Patients often ask, "How does a simple vascular enlargement prevent having children?" Based on clinical data in the field of andrology, the mechanisms through which varicocele causes infertility are explained in scientific detail.
Increase in Testicular Temperature
The primary reason testicles are located outside the body within the scrotum is that sperm production requires an environment 1.5 to 2 degrees Celsius cooler than core body temperature. In varicocele, the dilated veins act almost like a hot water bottle around the testicles. This temperature increase disrupts the structure and function of sperm-producing cells (germ cells), significantly reducing sperm count and quality.
Accumulation of Pooled Blood and Toxic Substances
In dilated veins, blood flow slows down and backward flow (reflux) begins. Waste products from the adrenal glands and pooled blood produced by the testicular tissue itself accumulate in the testis. This situation creates oxidative stress in the testicular tissue, reducing sperm motility, impairing sperm morphology (shape), and most importantly, increasing sperm DNA damage.
Decrease in Testosterone Production
In advanced stages of varicocele, Leydig cells in the testicular tissue can be damaged, which may negatively affect the production of testosterone, the male hormone. This both slows down sperm production and can pave the way for sexual reluctance. Microsurgical varicocelectomy completely breaks this negative cycle and restores healthy circulation in the testicles.