MESO-Rx
Anabolic Steroids
Varicocele and TRT
- Thread starter baja212
- Start date
The association of infertility with varicocele is well-known. Less well-known is low serum testosterone with varicocele. In your case, bilateral varicoceles might very well be contributing to the T level. Are you infertile?
Tanrikut C, Choi JM, Rosoff JS, Nelson CJ, Mulhall JP, Goldstein M. Improvement in serum testosterone levels after varicocelectomy. Fertility and Sterility 2007;88(Supplement 1):S386-S.
Gat Y, Gornish M, Belenky A, Bachar GN. Elevation of serum testosterone and free testosterone after embolization of the internal spermatic vein for the treatment of varicocele in infertile men. Hum Reprod 2004;19(10):2303-6.
BACKGROUND: To evaluate the effect of internal spermatic vein (ISV) embolization on levels of serum testosterone and free testosterone and on spermatogenesis. METHODS: The files of 83 infertile men treated for varicocele were reviewed for changes in serum testosterone, free testosterone and spermatogenesis after ISV embolization. RESULTS: Mean serum testosterone concentration rose after embolization by 43%, from 12.07 +/- 6.07 nmol/l to 17.22 +/- 8.43 nmol/l (P<0.001). Mean serum free testosterone concentration rose by 72%, from 5.93 +/- 2.44 nmol/l to 10.21 +/- 7.69 nmol/l (P<0.001). Mean sperm concentration increased from 7.49 +/- 1.73 x 10(6)/ml to 18.14 +/- 2.36 x 10(6)/ml (P<0.001); mean sperm motility increased from 21.74 +/- 2.47 to 34.47 +/- 2.27% (P<0.001); and mean sperm morphology increased from 6.63 +/- 1.07 to 13.08 +/- 1.44% (P<0.001). CONCLUSIONS: ISV embolization apparently induces an increase in both serum testosterone and free testosterone concentrations and in sperm parameters in infertile patient with varicocele, regardless of the size of the varicocele.
Cayan S, Kadioglu A, Orhan I, Kandirali E, Tefekli A, Tellaloglu S. The effect of microsurgical varicocelectomy on serum follicle stimulating hormone, testosterone and free testosterone levels in infertile men with varicocele. BJU Int 1999;84(9):1046-9.
OBJECTIVES: To analyse the effects of varicocelectomy on serum follicle-stimulating hormone (FSH), testosterone and free testosterone levels, and to investigate the interrelationships between seminal and hormonal variables. PATIENTS AND METHODS: The records were retrospectively evaluated for 78 infertile patients who underwent microsurgical inguinal varicocelectomy, with documented serum FSH, testosterone, free testosterone levels, sperm concentration and sperm motility before and after surgery. Left and bilateral varicoceles were detected in 40 and 38 patients, respectively. In addition, serum hormonal values of 10 fertile men in whom physical examinations and Doppler ultrasonography revealed no evidence of varicocele were recorded and used as a control group. RESULTS: The mean (sd) serum FSH levels of all patients decreased from 15.21 (3.34) before surgery to 10.82 (2.93) mIU/mL afterward (P=0.01), and serum testosterone levels increased from 5.63 (1.40) to 8.37 (2.2) ng/mL (P=0.01), whereas free testosterone levels increased from 23.13 (3.19) to 32.83 (4.37) pg/mL (P<0.001). In contrast to the significant difference in sperm motility before and after surgery of all patients (P<0.01), the difference in sperm count was insignificant (P>0.05). Thirty-six patients with high serum FSH levels before surgery had significantly lower levels afterward (P=0.001). In this group, the sperm concentration and motility also increased, from 17.66 (4.35) to 20.76 (4.37) million/mL (P=0.05) and from 30.9 (4.4)% to 37.5 (4.34)%, respectively (P=0.01). In the remaining 42 patients who had normal preoperative serum FSH levels, there was a slight decrease after surgery (P=0.02). Their sperm concentration increased slightly (P=0. 04), and motility also increased (P=0.001). Sixty patients had a significantly higher testosterone level after surgery; in this group the sperm concentration and motility increased (P=0.01). CONCLUSION: Varicocelectomy promotes Sertoli and Leydig cell function. The significant increase in serum free testosterone level results in a significant improvement in sperm concentration and motility.
Su LM, Goldstein M, Schlegel PN. The effect of varicocelectomy on serum testosterone levels in infertile men with varicoceles. J Urol 1995;154(5):1752-5.
PURPOSE: We evaluated the effect of varicocelectomy on serum testosterone. MATERIALS AND METHODS: We retrospectively reviewed the effect of varicocelectomy on serum testosterone levels in 53 infertile men with varicoceles. RESULTS: Mean serum testosterone increased from a preoperative level of 319 +/- 12 to 409 +/- 23 ng./dl. postoperatively (p < 0.0004). Men with at least 1 firm testis preoperatively had a greater increase in serum testosterone (p < 0.005). An inverse correlation was noted between preoperative testosterone levels and change in testosterone after varicocelectomy (r = -0.34, p < 0.013). CONCLUSIONS: Varicocelectomy can increase serum testosterone for infertile men with varicoceles. Although improvement in serum testosterone does not necessarily cause a direct improvement in semen quality, varicocelectomy may improve hormonal and spermatogenic function.
Currently, I don't know if I'm infertile now, I do have a 24yr old son, and just after he was born the Varicocele was discovered, I was 19yrs old at the time. My low Test is androgen induced. But you may be onto something??? Could my large varicocele prevent my Test levels from going back to normal?
I found the increase in TT interesting. I was once tested with regard to fertility. The Uro stated that as I probably could not even feel it, there was a very small varicole. I def had no idea it was there. I have a buddy who has one. WOPPER. Looks like a third nut!!!! So I would have never even considered myself to have an issue. Sperm were 40-60mil and 20 on worst day....Regardless.
While the testicles clearly store sperm and grow it on the exterior portion as attached to the rear side, You would think that might mean only the sperm need cooler conditions. After all they are basically kicked out of the testicle to this area as soon as they are incepted. Considering that major blood flow goes through the testicles, you would also wonder how they could operate at any temp short of 98.6, as an internal function. The blood moving through them is simply not going to perpetuate cooling! But the bags on the back, I could understand.
Perhaps T must be expedited out of the testicle as well? This would not make sense though as it functions within the body at 98.6. In fact, this perhaps proves that the internal operating temp of the testicle with relation to T production does in fact have to be 98.6!!!! Else how could they survive in the body?
Based on that I am going to guess there is a skew in place with this study. A temporary effect at best. Perhaps even psychological. What else could it be? Removing heat generated from veins that lay next to the Epididymis (sperm bags on rear) could certainly help them thrive as they are intended to be away from this heat in the first place. However, for T production which occurs inside the Testicle, and must live on inside the body at 98.6, any reduction in ambient temperature should not prove to benefit Testosterone production......IMO....
i of course find the results interesting. I also would attibute them as a direct relection of the power of the psychological impact on T production... You have to consider that a maie with that problem is going to have self esteem issues galore for starters. Forget about his new found potency and fertility. Finally he will surely be weilding his new physical profile with incredible confidence probably ehibited by the urge to "really tear it up!!"!. I am guessing these are the operational factors for this T increase........
While the testicles clearly store sperm and grow it on the exterior portion as attached to the rear side, You would think that might mean only the sperm need cooler conditions. After all they are basically kicked out of the testicle to this area as soon as they are incepted. Considering that major blood flow goes through the testicles, you would also wonder how they could operate at any temp short of 98.6, as an internal function. The blood moving through them is simply not going to perpetuate cooling! But the bags on the back, I could understand.
Perhaps T must be expedited out of the testicle as well? This would not make sense though as it functions within the body at 98.6. In fact, this perhaps proves that the internal operating temp of the testicle with relation to T production does in fact have to be 98.6!!!! Else how could they survive in the body?
Based on that I am going to guess there is a skew in place with this study. A temporary effect at best. Perhaps even psychological. What else could it be? Removing heat generated from veins that lay next to the Epididymis (sperm bags on rear) could certainly help them thrive as they are intended to be away from this heat in the first place. However, for T production which occurs inside the Testicle, and must live on inside the body at 98.6, any reduction in ambient temperature should not prove to benefit Testosterone production......IMO....
i of course find the results interesting. I also would attibute them as a direct relection of the power of the psychological impact on T production... You have to consider that a maie with that problem is going to have self esteem issues galore for starters. Forget about his new found potency and fertility. Finally he will surely be weilding his new physical profile with incredible confidence probably ehibited by the urge to "really tear it up!!"!. I am guessing these are the operational factors for this T increase........
The whole reason vericiles lower sperm production is because sperm are meant to be grown and stored in a place cooler than 98.6... They are therefore positioned outside the testicle on the rear for the majority of their lives prior to mission. When you have abnormally large vessels in the sac, they happen to come into contact with this area which is supposed to be protected from the 98.6 piping out of the main body. This heats their area up too much and hence sperm are damaged to varying degrees. In short, it dont help the beer to have a nuclear reactor sitting next to the ice cooler.......
I dont think the question was ever answered.... I dont think TRT is going to shrink the vericose veins in the sac.... TRT shinks the testicles because the presence of exogenous T in the system tells the testicles they no longer have to make T. So they shut down the plant. When the plant is shut down it shrinks cause all the workers atrophe with their lack of exercise....
This has no effect on whether the vein which is in place funtions. The Vessels in fact supplied to Ex T to shut it down, and continues to supply the exogenous T that continues to shut it down. They are most likely unrelated, unless one could prove that a shut down testicle requires less blood and the body made that adjustment. Possible to small degree I guess, but the material will remain....
I dont think the question was ever answered.... I dont think TRT is going to shrink the vericose veins in the sac.... TRT shinks the testicles because the presence of exogenous T in the system tells the testicles they no longer have to make T. So they shut down the plant. When the plant is shut down it shrinks cause all the workers atrophe with their lack of exercise....
This has no effect on whether the vein which is in place funtions. The Vessels in fact supplied to Ex T to shut it down, and continues to supply the exogenous T that continues to shut it down. They are most likely unrelated, unless one could prove that a shut down testicle requires less blood and the body made that adjustment. Possible to small degree I guess, but the material will remain....
Treating testes trouble early may save fertility
Treating testes trouble early may save fertility | Reuters
By Lynne Peeples
NEW YORK | Thu Nov 25, 2010 12:28pm EST
(Reuters Health) - Infertility is probably the last thing on teenage boys' minds. However, a new study out of Brazil suggests that early treatment of a common testicular condition could preserve future fatherhood potential for some adolescents.
A varicocele is a widening of the veins in the scrotum, which house the testicles. While frequently harmless, varicoceles can cause pain, testicular shrinkage and, over time, can potentially lead to lower sperm counts and quality.
The condition, which is similar to varicose veins, is estimated to affect 15 percent of men over 15. But it is found in more than a third of men being assessed for primary infertility -- an inability to biologically father a child -- and 80 percent of secondary infertility cases -- men who were once able to father a child but are not able to do so anymore.
Although varicoceles may not be the sole cause of infertility in all those cases, the close association with infertility and apparent worsening of the effect over time suggest early surgical correction of the flawed veins could have important benefits later on, the authors note.
"Because varicocele is a progressive disease, we want to know how soon we can intervene, especially because it does not cause infertility in all men," researcher Paula Toni Del Giudice of Sao Paulo Federal University, in Brazil, told Reuters Health in an e-mail. "Surgical intervention is not for everyone."
Del Giudice and her colleagues studied 21 boys between the ages of 15 and 19. They collected two semen samples before surgical correction of the varicoceles and another two samples at least three months after the varicocelectomy.
The team reports in the journal Fertility and Sterility that two important indicators of the sperm's functional health -- the integrity of the sperm cells' DNA and the activity of internal energy generators called mitochondria -- significantly improved after the surgery.
"Surgical intervention in adolescents indicated for varicocelectomy does improve sperm functional traits that are associated with infertility in adults, so there is an important benefit in performing this surgery," said Del Giudice.
The decision of whether or not to proceed with a varicocelectomy is typically based on testicular volume, or how much smaller the affected testicle is compared to the other, as well as a conventional analysis of semen quantity and quality.
The new study's additional measures of sperm damage "could represent another consideration when counseling patients and parents on whether to perform," Dr. Eric Seaman of the Urology Group of New Jersey, in West Orange, told Reuters Health.
Further, the surgery poses very little risk, according to Seaman, aside from the possibility of bleeding or infection that comes with any surgery. There is a small chance that a patient could also experience some uncomfortable post-operative fluid retention around the testicle, he said.
The total costs of undergoing a varicocelectomy, including hospital services and anesthesia, runs a few thousand dollars and is typically covered by insurance.
Still, Seaman does not suggest that parents need to rush their teenage sons into surgery. "If it sits a month, nothing will happen," he said. "A year could be another story."
"We feel that all young boys should be referred to an urologist for a full clinical evaluation, just as girls are referred to their gynecologists," added Del Giudice. "Not all adolescents will have a varicocele, and not all adolescents with a varicocele will need an operation."
Lacerda JI, Del Giudice PT, da Silva BF, et al. Adolescent varicocele: improved sperm function after varicocelectomy. Fertility and Sterility;In Press, Corrected Proof. Adolescent varicocele: improved sperm function aft... [Fertil Steril. 2010] - PubMed result
Objective - To assess the effect of varicocelectomy on sperm function (DNA integrity and mitochondrial activity) and levels of lipid peroxidation in seminal plasma of adolescents.
Design - Prospective study.
Setting - Patients recruited from a local public school.
Patient(s) - Adolescents (14-19 years old), Tanner stages IV or V with varicocele grades II or III, attending a local public school.
Intervention(s) - Two semen collections with a one week interval between collections before bilateral varicocele repair using subinguinal microsurgical varicocelectomy, and two semen collections with a one week interval between collections three months after the surgery.
Main Outcome Measure(s) - Rate of sperm DNA fragmentation as assessed by the Comet assay and categorized as classes I (no DNA fragmentation) to IV (high DNA fragmentation). Rate of mitochondrial activity as assessed by the diaminobenzidine assay and categorized as grades I (all mitochondria active) to IV (all mitochondria inactive). Levels of lipid peroxidation in seminal plasma by a colorimetric method that quantifies a lipid peroxidation subproduct (malondialdehyde).
Result(s) - Concerning DNA integrity, the samples after varicocelectomy showed more spermatozoa with intact nuclear DNA (grade I) and less spermatozoa with Comet grades II, III, and IV. Regarding mitochondrial activity, the samples after varicocelectomy showed less cells with inactive mitochondria (class III). No differences were observed in classes I, II, and IV. Concerning lipid peroxidation, no significant differences were observed.
Conclusion(s) - This study was able to demonstrate that varicocelectomy in adolescents is associated with increased sperm DNA integrity and mitochondrial activity. However, levels of seminal products of lipid degradation (malondialdehyde) are not different.
Treating testes trouble early may save fertility | Reuters
By Lynne Peeples
NEW YORK | Thu Nov 25, 2010 12:28pm EST
(Reuters Health) - Infertility is probably the last thing on teenage boys' minds. However, a new study out of Brazil suggests that early treatment of a common testicular condition could preserve future fatherhood potential for some adolescents.
A varicocele is a widening of the veins in the scrotum, which house the testicles. While frequently harmless, varicoceles can cause pain, testicular shrinkage and, over time, can potentially lead to lower sperm counts and quality.
The condition, which is similar to varicose veins, is estimated to affect 15 percent of men over 15. But it is found in more than a third of men being assessed for primary infertility -- an inability to biologically father a child -- and 80 percent of secondary infertility cases -- men who were once able to father a child but are not able to do so anymore.
Although varicoceles may not be the sole cause of infertility in all those cases, the close association with infertility and apparent worsening of the effect over time suggest early surgical correction of the flawed veins could have important benefits later on, the authors note.
"Because varicocele is a progressive disease, we want to know how soon we can intervene, especially because it does not cause infertility in all men," researcher Paula Toni Del Giudice of Sao Paulo Federal University, in Brazil, told Reuters Health in an e-mail. "Surgical intervention is not for everyone."
Del Giudice and her colleagues studied 21 boys between the ages of 15 and 19. They collected two semen samples before surgical correction of the varicoceles and another two samples at least three months after the varicocelectomy.
The team reports in the journal Fertility and Sterility that two important indicators of the sperm's functional health -- the integrity of the sperm cells' DNA and the activity of internal energy generators called mitochondria -- significantly improved after the surgery.
"Surgical intervention in adolescents indicated for varicocelectomy does improve sperm functional traits that are associated with infertility in adults, so there is an important benefit in performing this surgery," said Del Giudice.
The decision of whether or not to proceed with a varicocelectomy is typically based on testicular volume, or how much smaller the affected testicle is compared to the other, as well as a conventional analysis of semen quantity and quality.
The new study's additional measures of sperm damage "could represent another consideration when counseling patients and parents on whether to perform," Dr. Eric Seaman of the Urology Group of New Jersey, in West Orange, told Reuters Health.
Further, the surgery poses very little risk, according to Seaman, aside from the possibility of bleeding or infection that comes with any surgery. There is a small chance that a patient could also experience some uncomfortable post-operative fluid retention around the testicle, he said.
The total costs of undergoing a varicocelectomy, including hospital services and anesthesia, runs a few thousand dollars and is typically covered by insurance.
Still, Seaman does not suggest that parents need to rush their teenage sons into surgery. "If it sits a month, nothing will happen," he said. "A year could be another story."
"We feel that all young boys should be referred to an urologist for a full clinical evaluation, just as girls are referred to their gynecologists," added Del Giudice. "Not all adolescents will have a varicocele, and not all adolescents with a varicocele will need an operation."
Lacerda JI, Del Giudice PT, da Silva BF, et al. Adolescent varicocele: improved sperm function after varicocelectomy. Fertility and Sterility;In Press, Corrected Proof. Adolescent varicocele: improved sperm function aft... [Fertil Steril. 2010] - PubMed result
Objective - To assess the effect of varicocelectomy on sperm function (DNA integrity and mitochondrial activity) and levels of lipid peroxidation in seminal plasma of adolescents.
Design - Prospective study.
Setting - Patients recruited from a local public school.
Patient(s) - Adolescents (14-19 years old), Tanner stages IV or V with varicocele grades II or III, attending a local public school.
Intervention(s) - Two semen collections with a one week interval between collections before bilateral varicocele repair using subinguinal microsurgical varicocelectomy, and two semen collections with a one week interval between collections three months after the surgery.
Main Outcome Measure(s) - Rate of sperm DNA fragmentation as assessed by the Comet assay and categorized as classes I (no DNA fragmentation) to IV (high DNA fragmentation). Rate of mitochondrial activity as assessed by the diaminobenzidine assay and categorized as grades I (all mitochondria active) to IV (all mitochondria inactive). Levels of lipid peroxidation in seminal plasma by a colorimetric method that quantifies a lipid peroxidation subproduct (malondialdehyde).
Result(s) - Concerning DNA integrity, the samples after varicocelectomy showed more spermatozoa with intact nuclear DNA (grade I) and less spermatozoa with Comet grades II, III, and IV. Regarding mitochondrial activity, the samples after varicocelectomy showed less cells with inactive mitochondria (class III). No differences were observed in classes I, II, and IV. Concerning lipid peroxidation, no significant differences were observed.
Conclusion(s) - This study was able to demonstrate that varicocelectomy in adolescents is associated with increased sperm DNA integrity and mitochondrial activity. However, levels of seminal products of lipid degradation (malondialdehyde) are not different.
