Minimally invasive treatment helps with infertility

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A new study presented today at RSNA in Chicago reveals that embolization – a minimally invasive treatment for a common cause of infertility in men – can dramatically help a couple's chances for pregnancy.

"We found that spermatic vein embolization combined with anti-inflammatory treatment improves sperm motility and sperm count in infertile men with varicoceles," said Sebastian Flacke, MD, assistant professor of radiology at the University of Bonn in Germany. "Six months after treatment, 26 percent of couples had achieved a pregnancy."

Normally, blood flows to the testicles and returns to the heart via a network of tiny veins that have a series of one-way valves to prevent the blood from flowing backward to the testicles. If the valves that regulate the blood flow from these veins become defective, blood does not properly circulate out of the testicles, causing swelling and a network of tangled blood vessels in the scrotum called a varicocele, or varicose vein.

Previously treated with open surgery, varicocele embolization has grown in prominence as a minimally invasive outpatient alternative. To do this, an interventional radiologist inserts a small catheter through a nick in the skin at the groin and uses x-ray guidance to steer it into the varicocele. A tiny platinum coil and a few milliliters of a sclerosing agent to ensure the occlusion of the gonadic vein are then inserted through the catheter.

In a study including 223 infertile men, ages 18 to 50, with at least one varicocele, Flacke and colleagues set out to identify predictors of pregnancy after embolization of varicoceles in infertile men. An analysis performed on 173 patients three months after the procedure showed that on average, sperm motility and sperm count had significantly improved. Six months later, 45 couples, or 26 percent, reported a pregnancy.

"This study confirms that varicocele repair can significantly improve sperm count and motility," Flacke said.