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Will varicocele surgery help for better semen count?

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Practicing since : 1995
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I recently had a semem test done. It looks like the result are varied. svol - 5.0 ml, svis - sl decreased, scnt - 70.0 M/ml, smot 50%, mota 48% mots 2%, motnp 2%, smor 25% (these last for results were indicated that the was not dispersed into the flowsheet. What does this all mean? thank you
Posted Tue, 22 May 2012 in Men's Health
Answered by Dr. V. Sasanka 11 hours later
It would have been more useful if you mentioned why you had a semen test done.
Having said that, your reports do not indicate a major issue.
As per latest guidelines from WHO, a semen volume greater than 2.5ml, with a count greater than 16million/ml with more than 14% normal morphology and over 50% motility usually suggests a normal clinical picture.
Please let me know if you have any further issues - I will be more than glad to help you.
Above answer was peer-reviewed by
Follow-up: Will varicocele surgery help for better semen count? 2 hours later
I forgot to mention that I have had a verocoseal on the left side for over ten years and am planning to get it fixed. Would that improve the semem test? Could you expain the last four test results. (mota, mots, motnp, smor) Thank you.
Answered by Dr. V. Sasanka 2 hours later
That you have a varicocoele is usually no reason to get it operated, as studies have indicated that almost 10% of general population have a varicocoele, commonly on left side (95%) and quite of them suffer from no troublesome symptoms as a consequence.
Varicocoele repair is indicated primarily in patients with infertility, and that is where the semen analysis comes in - In patients with mild reductions in sperm quality, surgery 'might' improve some of the parameters such as motility or total count or morphology in upto 70% of carefully selected patients while there is no guarantee that it would definitely do so.
On rare occasions varicocoele surgery might be useful in patients who suffer from dull aching pain in scrotum, especially towards evenings, for which no other cause could be ascertained. Rarely in very large unsightly varicocoeles, surgery is indicated for purposes of cosmesis or to prevent testicular atrophy especially in young adults
When the pathologists do the semen analysis, they grade the kind of motility that sperm show. The sperm could show progressive motility, while some might be motile without any forward progression, while quite a few of them could be totally immotile - thus a healthy sperm usually should show about 50% progressive motility. This answers your last question (labs vary widely in the way they express their reports, and your lab probably says a for active, np for non-progressive,etc.). This is what I did mention when I answered you last time - your count is more than reasonably good, and the motility is about average for your age. whether you need to undergo surgery for varicocoele would depend on what your expectations are following the procedure.
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