Prevalence of Testicular Size Discrepancy in Infertile Men With and Without Varicoceles

Objectives

To compare the frequency of testicular size discrepancy between infertile men with and without varicoceles.

Methods

The records of adult patients presenting for male infertility evaluations were examined. The testicular volumes and presence or absence of varicocele and varicocele grade were recorded. Testicular size discrepancy was defined as a testicular size difference of at least 4 mL.

Results

Of the 3927 men presenting for male infertility evaluation, 3202 met the inclusion criteria of the study. A total of 705 patients (22%) had testicular size discrepancy and 1105 presented with a varicocele (34%). Testicular size discrepancy was found to be more common in patients with any varicocele than in patients with no varicocele (32% vs 17%; P <.001). In addition, testicular size discrepancy with a smaller left testicle was more common in patients with a left varicocele than in patients with no varicocele (30% vs 13%; P <.001). In patients with a left varicocele, testicular size discrepancy, if present, demonstrated a smaller testicle on the ipsilateral side 89% of the time and on the contralateral side 11% of the time. In contrast, with a right-sided varicocele, if testicular size discrepancy was present, the smaller testicle was located only on the left side.

Conclusions

Testicular size discrepancy is approximately 2 times more common in infertile men with varicoceles than in men without varicoceles. Testicular size discrepancy with a smaller left testicle is more common than size discrepancy with a smaller right testicle, regardless of the side of the varicocele.