Embolization of the spermatic vein for treatment of infertility: a new approach.

A new transjugular technique for spermatic venography and nonsurgical transcatheter occlusion of incompetent spermatic veins is described. With this technique, the left spermatic vein was easily catheterized in 28 of 30 patients examined, and in 21 patients the vein could be occluded. Right spermatic vein catheterization was attempted in 25 patients. Right-sided spermatic vein occlusion was successful in 17 of 24 patients. The vein could not be selectively entered only twice. Bilateral incompetence of the spermatic veins in men with primary sterility is the rule rather than the exception. Valvular incompetence does not necessarily produce a clinically detectable varicocele. Bilateral venography is indicated in all men with abnormal spermiograms.