Varicocele Surgery and Improved IVF Success


#1

Hi ladies,

With 2 failed IVF cycles behind me, I am ready to make a change before our next attempt. In both IVF cycles, our fertilization rate was below average (around 50% with ICSI) and our embryos disintegrated quickly in quality beginning on day 3. I am hoping my hubby’s varicocele is impacting sperm quality and compounding our infertility issues so I just signed him up for the varicocele surgery! I realize this is a strange thing to “hope” but if it isn’t his sperm then it has to be my eggs and there is absolutely nothing we can do to dramatically improve egg quality so…

We will wait 6 months before another IVF cycle so his sperm will be perky and healthy and all the waiting kills me!! Does anyone have any success stories to share during the wait about increased sucess with IVF after varicocele repair surgery?


#2

What grade is your husband’s varicocele? The worst the varicocele (ie grade 3) then more likely you’ll see improvement. I’ve seen on these boards men who’ve gotten improvement in SA numbers after surgery and others who didn’t
My husband has a grade 1 varicocele and the first urologist said he would have a 50/50 chance of improvement after surgery. The second urologist said that surgery wouldn’t improve his numbers significantly, so we decided to do fertility treatments instead.

I would disagree with you that there is nothing you can do to improve egg quality. Eating healthy, doing moderate exercise, and getting enough sleep might make some difference. Also, there is some truth to quality over quantity. 48 eggs retrieved seems like you might be able to scale back the dosage during stimming to improve egg quality. Personally, I took DHEA and royal jelly for a couple of months before my second IVF. Also, a study came out showing that acupuncture in the 2 days before or after transfer improves odds of implantation.

Having said all that, if you think that surgery will improve your odds, and it very well might, then I would go for it.


#3

Thanks for your reply. I haven’t been given a ‘grade’ of my hubby’s varicocele BUT it is large (easily visible to the eye) and the urologist mentioned that his testicle was significantly smaller as a result of the varicocele. My hubby thinks he has had it since high school. We also opted not to treat the varicocele and go the path of fertility treatments. In 2009, several SA’s showed that my husband had decent (moderately low) count and motility and very low morphology. We still got pregnant fairly quickly with IUI. Trying for baby #2, we have several IUI’s and 2 IVF’s behind us without success which is why I am back to wanting him to have the surgery to see if it could make a difference on the quality of his sperm.

I think the reason my RE didn’t think egg quality could be drastically improved is that I am already 30, have never smoked, and live a healthy lifestyle. I did take several supplements (DHEA and royal jelly among them) before my last IVF cycle. I do think I was probably overstimulated (although I didn’t develop OHSS). I also wonder if that could have effected results but my results were very similiar with only 16 mature eggs retrieved my first IVF cycle so…

Thanks again for your response.


#4

If the varicocele is visible to the eye, then it probably is a grade 3.
There are a couple of other tests you can do to assess sperm quality. I’ve read about the DNA fragmentation test. From what I’ve heard (from women on these forums) there’s not much you can do to improve sperm DNA fragmentation but it’s useful for knowing if it’s contributing to poor embryo quality.
My husband did the hyaluronan binding assay, which looks at how much of the sperm binds to hyaluronan coated on a slide. Basically it assesses whether the sperm would be able to bind to an egg. Normal numbers are 70-80% binding, but my husband had 10% binding. Because of the low numbers, we were advised to do P-ICSI for our IVF cycle.
Did you do ICSI or P-ICSI for your two IVF cycles?


#5

Thanks for responding Careen! I just got the results back from my hubby’s DNA fragmentation test. It was only 34% fragmented which is in the average to poor category. I honestly don’t think this % helps explain our super low fertilization rate and degenerating embryo quality. Everything points back to my eggs but it just doesn’t make sense for me to have such the short end of the stick! sigh Why did your hubby’s doctor order to hyaluronan binding assay? Why did they suspect a problem in this area? I haven’t heard of this one.

Our first 2 IVF’s have been done with ICSI. I may need to research P-ICSI to see what the difference is. I am feeling so desperate and defeated lately!


#6

Josie, sorry for the late reply, I had some family issues I had to attend to. I can only imagine how defeated you must feel. I wish I had an answer for you. Maybe it’s a lot of small things that contributed to the BFN or maybe it’s just a case of bad luck. Our doctor did the binding test as part of his protocol. I don’t think it’s very common and I haven’t come across other women who’ve had it done on these boards. Some doctors say that ICSI is just as good a P-ICSI and other doctors say P-ICSI is better. I don’t think there have been any conclusive studies about that. I hope everything works out for you. Let me know what your next step will be. Have you scheduled varicocele surgery?