​I've had many clients with horror stories. Recently one that made me very upset was when I was contacted by a teenager from India. He was a 19-year-old boy. He had already undergone 3 operations: Two surgeries and one embolization. And guess what: He didn't even have pain before his first operation, but now, he has permanent pain. Unfortunately, I told him that I likely can't help him. These procedures have risks and developing permanent, chronic pain is possible. I gave him a copy of my books and yoga series for free and offered to advise him in his treatment--free of charge. My treatments are helpful for those who have previously undergone surgery, but, 3 operations at 19? Who knows how it will go.​

Before considering surgery, you need to know the NNT, and the complete list of benefits vs risks.

In order to repair a varicocele the following criteria should be fulfilled 1:

1. Involuntary infertility of at least one year.
2. Presence of a palpable varicocele at the upright position and during a Valsalva manoeuver.
3. No detectable or at least no irreversible cause of female infertility.
4. Normal testicular size (> 15 cm3) or small reduction of the ipsilateral testis 2.
5. Evaluation of at least two semen analyses at three months interval. The presence of normal semen analyses excludes varicocele as the cause of infertility. The usual effects of varicocele on sperm parameters include mild and moderate asthenospermia, teratospermia or astheno- teratospermia. Initially, sperm concentration is not seriously affected, though later all three semen parameters can gradually deteriorate, resulting in azoospermia in very few cases 3.
6. Normal values or slight increase (less than the double of the upper normal range) f serum FSH levels, as very high levels of serum FSH denote primary testicular failure.

Additional factors that must be considered before deciding the therapeutic approach of varicocele in an infertile couple include 4:

1. The advanced age of the wife (older than 35 years) and high serum FSH levels should drive the decision towards the ICSI solution rather than repair of varicocele 5.
2. In case of chronic presence of varicocele and advanced male age, surgery should be avoided.
3. Surgical repair of varicocele is recommended in case of secondary male infertility 6, 7. On the other hand, if the patient has primary infertility, azoospermia, small testicular size and high serum FSH levels, the presence of varicocele should be ignored and surgery should be avoided, as the diagnosis in this case pleads towards primary testicular failure.
4. The diagnosis of SCOS or maturation arrest in FNA or open testicular biopsy denotes primary testicular failure. Thus, the presence of varicocele should be ignored. On the contrary, the presence of mild or moderate hypospermatogenesis can be attributed to varicocele in which case surgery can be a reasonable therapeutic approach.

Varicocele surgery is not a cure. It is simply another treatment method for varicocele.

• You do not return to a normal/healthy baseline post-surgery.
• Cutting out swollen veins is not curing them.
• Surgical benefits are questionable.
• Surgery is a high risk procedure.

Your new best friend is the term Number Needed to Treat (NNT).  The NNT is statistic used in to communicate the effectiveness of a health-care intervention. The NNT is the average number of patients who need to be treated to produce one positive outcome.

What do you think the NNT is for varicocelectomy? It's 7 [1, 2]. That means for every 7 men who undergo varicocele surgery, only 1 additional pregnancy is attained. That's only 14%. Only 14% of men who undergo varicocelectomy attain a benefit. Is that a cure? I think not. Good physicians generally do not recommend varicocelectomy. Actually, many scientific publications have found that varicocele surgery is not effective at all for improving pregnancy rates! [3, 4, 5, 6, 7, 8].

Oh and the the benefits of varicocelectomy for pain relief is simply questionable and not recommended. There is simply too little research done on the topic. 

Now, maybe that doesn't sound so bad to you... But if you consider the fact that you're more likely to suffer from severe negative side effects than to attain a benefit, then things get put into perspective. And the potential side effects are very serious. We're talking about hydrocele formation, onset of pain (which can be permanent), testicular loss due to artery rupture, internal bleeding, and persistent recurrent varicocele to name a few. (Comprehensive: Surgery risks & benefits).

The benefits may be uncertain, but the risks are very real. Now, would you even consider surgery knowing all this?

If you thought the NNT for varicocelectomy was bad, you won't even want to know what the NNT for embolization is... Well, I'll tell you anyway: It's 17. [9] That's right--for every 17 men who undergo embolization, only 1 additional pregnancy is attained. That's 6%. And embolization isn't a low risk procedure. You're looking at up to 30% varicocele recurrence rate (depending on the skill of your radiologist and which side you treat). (Comprehensive: Embolization risks & benefits).

Now, keep in mind that there is no cure for varicocele.

• Surgery is not a cure (comprehensive breakdown of pros and cons of surgery)
• Embolization may help 1 in 17 men (6%), but still not a cure
• No medication for curing varicocele (only used for temporary relief)
• No supplements or herbs (maybe help about 5% total--careful of scams!)
• Not even my natural treatments (but are pretty damn good now!***)

But, what makes my treatments The BEST? Well:

1. My treatments are pretty effective (just read the reviews)
2. My treatments are affordable ($39 to $149)
3. My treatments are not only completely risk free--they're also good for your health (learn more about Varicocele Natural Treatment)
4. No real alternatives (Supplements? Good luck.)

Do you really need any more reasons? Start now!