Left spermatic vein cortisol in subfertile men with varicocele

Varicocele is one of a number of well-documented causes of male subfertility. In patients undergoing varicocelectomy high success rates are achieved postoperatively, with improved women quality and subsequent pregnancies. Why varicocele causes subfertility in some men is unknown. Recently, it has been hypothesized that the left spermatic vein might be rich in by-products of adrenal metabolism, thus leading to diminished spermatogenesis. This study does not support this hypothesis, finding no significant difference in plasma cortisol in the left spermatic vein than from distant peripheral circulation. Further investigation into the etiologic factors causing subfertility with varicocele is recommended.