Possible varicocele, due to start ivf in five weeks! Help!

[MrsBP15]

Hi everyone

so we were all on track to start medication at the very start of September. My husband finally decided to visit the doctor last week having had a slight dull ache on and off in his balls for a few months. Doc said couldn’t feel any lumps and bumps so all good there but that there might be varicose vein causing discomfort and he would order an ultrasound to check. I pointed out to my husband that that could (and likely would) take months to come through and we frankly don’t have months if we want to start in September. He’s going to contact our specialist to see what can be done and if we need to pay for an ultrasound we will. He has had a semen analysis which came back very good so I suppose my questions are:

can a varosele develop over time and would it make a significant difference to sperm that was already looking v good?

do the procedures to deal with them take a long time to recover from?

is all of this a bit of a moot point as far as ivf is concerned (sorry I don’t have a clue)!

I know we will get some answers from the specialist but I’m just anxious to hear other people’s experiences asap especially as we are due to go away for 10 days on 10th 😬

thank you so much. Any/all help very welcome!🙏🏻

I highly recommend addressing the varicocele first.

What’s the reason you’re doing IVF in the first place? Is it MFI?

If he does indeed have a varicocele it could be affecting his sperm DNA fragmentation %, even if his other sperm parameters are normal. If that’s the case, you need to be aware that high DNA frag can significantly impact your IVF results (e.g. lower fertilization, lower blastulation, higher chance of miscarriage etc). ICSI can sometimes bypass some of this, but it’s no substitute for healthy sperm.

In an ideal world you should investigate this possibility and get any issues his side fixed to improve your IVF outcomes down the line. That’s worth postponing treatment by a few months - unless there’s a reason (age or other) your doctor has advised you to start treatment asap.

If there are no fertility issues on your side, and the varicocele/DNA frag is what’s causing your infertility, getting it fixed could mean you don’t even need to do IVF in the first place.

Thanks for your response @giraffesauce the fertility issues (as far as we know) are solely on my side as both my fallopian tubes are completely blocked hence ivf. We could delay for a few months if we needed to although I would want to get cracking sooner rather than later as I’m 38 and we’ve already been trying for 2 years (not as long as some I know). Do you have experience of varicocele? Does it take a while to recover from?

We did IVF because of my husband's high DNA frag and varicocele is one of the things we investigated as possible causes. He didn't have it but I've read countless stories of people who did, got it fixed and then went on to conceive without intervention (or saw significantly better results with IVF). It's quite a common diagnosis.

I would definitely see what your specialist says but my understanding is that the varicocele impacts the quality/DNA of the sperm that is being produced while the varicocele is there. So once you remove it you need to give the testicles enough time to generate new, healthy sperm, which takes 70-80 days. So yes it would set you back a few months.

I completely understand your concerns with age and wanting to get started asap, but if the issue your side is blocked tubes (and not for example diminished ovarian reserve) a few months won't actually make a difference. On the other hand, if you embark on IVF with healthier sperm it could mean the difference between only having to do 1 vs. more cycles...

Of course all of this is hypothetical and you should definitely speak to your consultant first!

Hiya,

My husband had varicocele which affected his sperm count on all parameters and high DNA fragmentation. We did ICSI (although he was on all kinds of supplements beforehand) and were lucky to get pregnant with our first round. Subsequent rounds with embryos from same batch failed. He also had varicocele embolisation (after the ICSI) and now his numbers and DNA frag are within normal range. However I still haven't been able to conceive naturally and we have both been checked. I think it might help to get the varicocele sorted first to improve your chances or at least check the DNA frag first to see it it's impacted x

My husband was found to have a varicocele when we started investigations. Decided to try to fix it first as read so much about how it causes dna fragmentation and oxidisation, lots of threads about embryos stalling at day 3 when the make gene takes over. Sadly for us, my husband was in the 10% of men whose was in such a tangle the surgeon couldn't safely embolise it. We were gutted, paid privately to try to expedite things and husband went through the procedure for nothing.

So, we had to go into ivf with a severe varicocele and awful sperm parameters on all fronts, and of course had ICSI due to male factor. From all we read we decided to do life style changes (no caffeine, no baths, took proxeed daily, loose boxers, no alcohol) in the 3 month run up to our cycle. He also most importantly ejaculated every other day to try and keep the supply fresh and avoid oxidisation. The clinic also said only abstain fir 34 hrs before the ivf sample, usually its something like 48 to 36 hrs I think, expressly to provide a very fresh sample.

Got 7 eggs from me, all were mature and all fertiised. Rang everyday (went private so clinic provided daily updates) to check on them as we were expecting to lose them especially after day 3. To our surprise all made it to day 5 at excellent or good grade, though one slowed down and wasn't frozen so had one fresh transfer and 5 frozen. Fresh didn't take but the first frozen one did two months later, and he turned one last week!

Long story but just a positive one of ivf working with a varicocele. I was 34 and no problems on my side.

I see your husbands parameters are good, they don't check for fragmentation though but I do think frequent ejaculation helped my husband there.

Could you possibly do an egg collection and freeze all for you while your husband has his varicocele embolised if youre worried about age (depending on what your NHS trust thinks may need to be private to be quick as they often don't operate unless it's causing pain). Then when his parameters have improved can do a fertilise and transfer? Not sure if thats an option.

24 hrs not 34!*

Hi all thank you for sharing your stories that sound really positive despite the various issues you and your partners faced. I should stress that a varicocele has not been diagnosed yet. I realise there is a high chance this is what is related to the ache he has been experiencing on and off but it’s worth noting we don’t actually know that’s what it is. Also we are undergoing treatment privately as we do not qualify for any rounds on the nhs so that was never an option for us. Our next step is to speak to the specialist to see if anything can be done via the clinic and if not, we will look to book some tests privately as we are very lucky we can do this and I don’t want to be hanging around for months waiting for nhs appointments to come through. The last nhs scan I had took six months to come through and whilst I’m happy to delay by a few months if we need to, I certainly would like to have done our first round by the end of the year! That’s a really good point about freezing eggs @Imisscoffee2021 if we need to, I’ll see what the specialist says. I know this doesn’t say anything about the quality but I am fortunate enough that my AMH is pretty high (36.5) so that’s something at least and I’ve been taking supplements (as has my husband) for many months so I’m hopeful that this (along with lifestyle changes) will have made a difference (though I fully understand there is only so much one can do).

thank you again for your help. I really appreciate you taking the time to post, especially as it is all super useful!x

@MrsBP15 coming from the side where my OH had a varicocele and the reason we need ivf is male factor….if the semen parameters are good and no sign of a varicocele then I would just go ahead with your cycle. If there is a varicocele in my experience the clinic will still recommend you go ahead with the cycle, but if you don’t get the desired outcome then possibly look at treatment. What I will say is our first round to second round was a vast improvement in sperm quality and embryo numbers but I have so far used 4/10 from the second round and haven’t yet been successful so although the varicocele embolisation has helped we haven’t yet got over the line. My OH was in quite a bit of discomfort and nhs still didn’t recommend the embolisation they said to take paracetamol so we went private cost about £3.5k