OBJECTIVES: To evaluate the reproductive outcomes of infertile couples with a clinical varicocele and advanced paternal age. METHODS: We reviewed the clinical records of 581 consecutive, non-azoospermic men presenting with a clinical varicocele and infertility. RESULTS: We identified 115 men aged 40 years and older and 466 men younger than 40 years with a clinical varicocele and infertility. The proportion of men with secondary infertility was significantly higher in the group of men aged 40 years and older compared with the men younger than 40 years (43% [50 of 115] versus 19% [87 of 466], respectively; P <0.001). There were no significant differences in baseline sperm parameters and in spontaneous pregnancy rates after varicocelectomy in couples with advanced paternal age (40 years or older) compared with the younger couples (49% versus 39%, respectively). However, the spontaneous pregnancy rate in couples with advanced paternal age (40 years or older) who underwent varicocelectomy was significantly greater than that of the age-matched control group who did not undergo surgery (49% versus 21%, respectively; P <0.05). CONCLUSIONS: The results of this study suggest that paternal age does not adversely influence pregnancy outcome after varicocelectomy. The data support the practice of varicocelectomy for treatment of clinical varicocele and infertility in older men.
OBJECTIVES: To evaluate the reproductive outcomes of infertile couples with a clinical varicocele and advanced paternal age. METHODS: We reviewed the clinical records of 581 consecutive, non-azoospermic men presenting with a clinical varicocele and infertility. RESULTS: We identified 115 men aged 40 years and older and 466 men younger than 40 years with a clinical varicocele and infertility. The proportion of men with secondary infertility was significantly higher in the group of men aged 40 years and older compared with the men younger than 40 years (43% [50 of 115] versus 19% [87 of 466], respectively; P <0.001). There were no significant differences in baseline sperm parameters and in spontaneous pregnancy rates after varicocelectomy in couples with advanced paternal age (40 years or older) compared with the younger couples (49% versus 39%, respectively). However, the spontaneous pregnancy rate in couples with advanced paternal age (40 years or older) who underwent varicocelectomy was significantly greater than that of the age-matched control group who did not undergo surgery (49% versus 21%, respectively; P <0.05). CONCLUSIONS: The results of this study suggest that paternal age does not adversely influence pregnancy outcome after varicocelectomy. The data support the practice of varicocelectomy for treatment of clinical varicocele and infertility in older men.