Happymel, we've had a very interesting varicocele journey...
It all started when my first gyn prescribed clomid and asked DH to have a semen analysis. The gyn gave us the bad news that DH had crappy sperm over the phone, and when he also gave me the bad news that clomid hadn't worked for me over the phone (after chasing him for three days to get a day 21 blood test result!) I swore I would never have anything else to do with him again. Meanwhile, my acupuncturist got DH to go to a specialist semenologist to have a better SA done. Results came back with bad morphology, bad motility and low count. The summary was "unfit for natural conception". My acupuncturist started talking varicoceles, and we eventually got DH off to a GP for a check up.
There's 4 grades of varicoceles. Grade 1 is subclinical - can only be found by ultrasound scan. Grade 2 - varicocele can be felt only while straining (they call it a valsalva technique, or something like that). Grade 3 - varicocele can be felt normally, and Grade 4 is where the varicocele causes pain. DH has a grade 3.
My acupuncturist has suggested embolisation as being better - less traumatic and quicker recovery. The first urologist DH went to would only talk surgery and DH is a little freaked out about that.
Meanwhile, our FS handed us a Cochrane review and told us that while repairing the varicocele may improve semen paramaters, it would not improve pregnancy rates, so we may as well do IVF anyway. As I have PCOS the clinic would do ICSI anyway, and DH's sperm need ICSI so there was no point to doing the repair unless it bothered him.
We went away and did a stack of research. A friend in England went through the Cochrane review and picked faults in the studies we could actually get hold of. Essentially, a lot of the studies dealt with men who have sub-clinical varicoceles and a normal semen analysis anyway. If you get to a study that deals with men with thumping great big varicoceles, normal hormone profiles and no other factors effecting fertility, then the varicocele repair DOES in fact improve sparm quality and number and DOES increase pregnancy rates. I still have the critique that my friend did on it... very interesting.
DH was happier with the embolisation idea so we went off to urologist number 2. Urologist number 2 sent us to RPA to have the embolisation done there (so much for staying local! We're at Windsor!), and they couldn't get to the right place as DH has funny veins. We know of a team that goes from the neck down rather than the groin and up and around, so there may be a chance the alternative route will get us to the right place, or it could mean that DH is up for surgery as well.
So... anything else you want to know about varicoceles?
Thanks so much for the good luck wishes for the transfer... I'm still freaked out by the whole idea. Excited, nervous, happy, terrified... I'm glad I've got time between now and Monday to calm down, and the weekend to de-stress... Wheeeee! What a day!
Wow BW - excellent news! Your description of you running around the room waving your arms about in circles made me laugh! I can imagine that I will react exactly the same way when I find out about my first EPU/ET date! Congratulations and lots of positive vibes coming your way for Monday and beyond
Hi Happymel - both DP and myself were in the defence force as well. Our experience and others that we know of who were in the same system was that they would always try to find the best doctor or surgeon in their field to do any surgery or procedures. There is just too much as stake for them to go with a cheap option as the liability cases down the track would be very costly if things went wrong. So, have faith that if surgery is the way to go then they will refer you to someone who is well respected in their field, but as always, ask lots and lots of questions and trust your gut feeling.
To everyone else, good luck with everything, must go. Chat soon.
BW and Chez, thanks for all your info. Wow BW- you seem to know everything about varicoceles. I think DH must be stage 3 i will have to ask if i ever see this urologist!! It just never seemed obvious before but can see it now. You can feel it easy and also see it when he is standing up but not so much sitting down. I think we feel that we will just have the surgery and whatever happens happens. If it makes a difference then thats great but if it doesnt, well at least we have tried everything. Chez- the defence force have kinda been ok, except dont want anything to do with paying anything on the ivf even though FS thinks they should, as reason we are doing ICSI is because of male infertility, and dont seem to think endo is problem. Sometimes they are so frustrating GRRRR. Already DH was away for our first IVF cycle Im sure the urologist will be fine, he was just rude!! Happy i wasnt there!! OOoo i dont like rude doctors!! So many questions to ask FS when next see him. Im just worried they are concentrating and thinking its mainly a male factor infertility, and that my endo doesnt really make a diff. I hope they are right. I had stage 4 end (severe) dx at lap last year Nov and removed, also endometrioma taken off ovary.
Rols- great to see a guy on here and have male perspective too. Its good to hear things from another point of view.
Im sure the urologist will be fine, he was just rude!! Happy i wasnt there!! OOoo i dont like rude doctors!! So many questions to ask FS when next see him. Im just worried they are concentrating and thinking its mainly a male factor infertility, and that my endo doesnt really make a diff. I hope they are right. I had stage 4 end (severe) dx at lap last year Nov and removed, also endometrioma taken off ovary. 
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