Bilateral varicocele surgery - Does it improve IVF ICSI results?

[Shivaya2020]

Hi, we have had 2 failed cycles of IVF + ICSI and seems like the quality of our embryos need to be improved. They have given both of us supplements etx but since my husbands sperm parameters are not optimal and he has a varicocele (more prominent on left side), they have advised he undergoes bilateral varicocele surgery. Wondering if anyone has experiences of improvement in IVF outcome with this?

[Hidden]

100% - don't do IVF again until you have this surgery.

Before surgery, we got ZERO blastocysts, after surgery, we got three blastocysts and I finally got pregnant (although ended in miscarriage, but furthest we have got)

x

[Shivaya2020 in reply to Hidden]

Thanks Hidden ! What grade of varicocele did you’ll have? Also after how many months of the surgery did you do the IVF? Trying to understand the wait time as time is also sensitive for us.

We are getting mixed opinions from the IVF specialists, some are saying that the improvement is only in 30% cases as ours is Mild varicocele.

[Maui2020]

Hi Shivaya2020. My husband had a severe varicocele in 2016, we weren’t even eligible for ICSI, they were discussing IMSI. He got it corrected and in 3 months we managed to do ivf and great fertilisation without ICSI. We got a little boy eventually with the right protocol. Now we are trying for a sibling, we had all rechecked and he had a mild varicocele on the other side. We made the decision to treat as he had raised DNA fragmentation on the comet test. It was a catch 22, because it has set us back time wise, but we always have an issue with embryo quality and I couldn’t face doing another round with the possibility that could be causing it. Also Dr said it was bigger than was suggested on the scan. We didn’t recheck comet result as that would have set us back longer, we just dived into a cycle of ICSI 2 months later.. Hope that helps x.

[Shivaya2020 in reply to Maui2020]

Thanks Maui2020 ! Can i ask what was the DNA frag the 2nd time your husband had mild varicocele?

My husband has a DFI of 21% & mild varicocele and infact before IVF the urologist had not suggested surgery, but only since embryos are arresting the urologist suggested to do it.

My IVF doc thinks that bcoz its mild, no point of doing it as it may not improve things. So then why lose 3 months. So i am really confused.

We are good to go ahead with the surgery, only thing that is stressing us is the wait time of 3months +

[Maui2020 in reply to Shivaya2020]

The DNA frag on the Comet test was 32%, I’m not sure if that’s comparable with other types of tests as I know there are a couple. It’s funny you say that, as our andrologist thought treatment was a vital step, but when we went to see a new IVf Dr he thought the whole thing had been uneccessary and we didn’t even need ICSI! But it was hard as our frozen embryos were also arresting and failing to implant, but they were not able to give any explanation for that.

Does your ivf Dr have any suggestion of improving protocol so you don’t keep getting the same results?

[Shivaya2020 in reply to Maui2020]

Omg your experience feels so similar, its crazy when the ivf doc n androlgist dont communicate directly.

The ivf doc feels it cud be egg quality and is suggesting a different protocol (dualstim) which has shown to give better quality eggs. And secondly, grow the embryos till blastocyst

Actually, we have only done Day 3 transfer in our last 2 cycles given we were unsure of them growing, so we dont even know if we have Day 5 embryos at all.

[Shivaya2020 in reply to Shivaya2020]

Essentially even after 2 cycles, they are not able to tell if its a egg problem or sperm problem. They want to use the 3rd cycle to understand that, and we dont want to this as an experiment as its clearly not for any of us undergoing it.

[Maui2020 in reply to Shivaya2020]

Oh same here, and as far as I know they can’t tell whether it’s sperm or egg completely. In our case we had well graded lovely looking blastocysts in the freezer that just weren’t surviving thaw. So something was clearly wrong. My previous Ivf Dr had said, we can go for another round and if it doesn’t work then we can investigate sperm further.. which is what drove us to do the surgery without question, as we didn’t want the “let’s experiment” philosophy.

If you do go ahead ask you urologist if you could start 2 months later instead. I was desperate to not wait the 3 months post surgery as it would have taken us into Dec which is when clinics shut for Xmas, so even more delay. It worked out ok as by egg collection day it had been almost 3 months since the surgery anyway.

So many hard decisions, but I hope that it all ends up in your favour xx

[Shivaya2020 in reply to Maui2020]

Thanks Maui2020 for your response. I see where your coming from.In my last 2 cycles, they did Day 3 transfer and hence my ivf doc feels that we shud do one more cycle where we take to Day 5 before deciding on the surgery.

but as you said i dont want to experiment, given its my 3rd cycle.

Gosh all this is so confusing, thanks for your support

[K8dferXdder]

hi all, looking for tips on clinics where to have bilateral varicocele treatment for my husband. Please PM me with a clinic name and cost please. We woukd travel anywhere in the UK to get it treated at a reasonable cost!

Do you think treating it led to your success?