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1567404 
Journal Article 
Pathophysiology of varicocele in male infertility in the era of assisted reproductive technology 
Shiraishi, K; Matsuyama, H; Takihara, H 
2012 
Yes 
International Journal of Urology
ISSN: 0919-8172
EISSN: 1442-2042 
19 
6 
538-550 
22417329 
WOS:000304344700008 
Varicocele is the most common and treatable cause of male
infertility. Studies of a rat experimental left varicocele model and human testicular biopsy
samples have shown the involvement of various factors in its pathophysiology. Among them,
oxidative stress plays a major role in impairing spermatogenesis and sperm function. Therefore,
in addition to palpation, scrotal ultrasonography and color Doppler ultrasound, evaluation of
testicular oxidative stress (e.g. scrotal temperature is a surrogate parameter) is recommended to
enable diagnosis and suitable treatment of varicocele. Varicocelectomy increases the
fertilization, pregnancy and live birth rates, indicating improved sperm function; it is
therefore important even in couples undergoing intracytoplasmic sperm injection. Routine sperm-
function tests are warranted to monitor the sperm quality after varicocelectomy and consequent
improvement in the outcomes of assisted reproductive technology. Furthermore, the indications of
varicocelectomy in assisted reproductive technology should be widened. 
assisted reproductive technologies; oxidative stress; varicocele